Agent for the prevention, improvement or treatment of retinal disease

ABSTRACT

A prophylactic, ameliorating or therapeutic agent for a retinal disease, the agent comprising geranylgeranylacetone which
     (a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and (5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetone content of the mixture being 80% by weight or more,   (b) consists of (5E,9E,13E)-geranylgeranylacetone, or   (c) consists of (5Z,9E,13E)-geranylgeranylacetone directly suppresses the death of a retinal cell, thereby fundamentally preventing, ameliorating or treating the retinal disease.

TECHNICAL FIELD

The present invention relates to a prophylactic, ameliorating ortherapeutic agent for a retinal disease.

BACKGROUND ART

Teprenone (Eisai Co., Ltd.) is a mixture of(5E,9E,13E)-geranylgeranylacetone and (5Z,9E,13E)-geranylgeranylacetoneat a weight ratio of 3:2. Teprenone is widely used as an oraltherapeutic agent for gastric ulcer.

The use of teprenone in the ophthalmic field has been suggested. Forexample, Patent Literature 1 teaches the use of teprenone as an activeingredient of a prophylactic or therapeutic agent for dry eye, eyestrain, or eye dryness. Patent Literature 2 discloses a clear eye dropconsisting of teprenone, a phospholipid, a synthetic surfactant, andwater.

Geranylgeranylacetone with an unknown cis-trans isomer ratio (Eisai Co.,Ltd.) is also known to be useful as an active ingredient of atherapeutic agent for a retinal disease.

For example, Patent Literature 3 teaches a method for ameliorating anocular disease such as diabetic retinopathy and glaucoma in a patient,the method comprising administering geranylgeranylacetone to the patientto increase the expression or activity of a heat shock protein in anocular tissue, and recruiting a stem cell to the ocular tissue, therebyameliorating the ocular disease.

Non Patent Literature 1 teaches that intraperitoneal administration ofgeranylgeranylacetone to a retinal detachment-induced animal induced theexpression of heat shock protein 70 and subsequently reduced theapoptosis of visual cells significantly.

Non Patent Literature 2 teaches that intraperitoneal administration ofgeranylgeranylacetone to a glaucoma rat model induced the expression ofheat shock protein 72 and subsequently reduced retinal ganglion celldeath and thereby ameliorated optic nerve damage.

Non Patent Literature 3 teaches that oral administration ofgeranylgeranylacetone to a mouse with visual cell damage induced bylight irradiation induced thioredoxin and heat shock protein 72 in theretinal pigment epithelium. The literature also teaches that the releaseof thioredoxin from the retinal pigment epithelium plays a crucial rolein maintaining visual cells and that geranylgeranylacetone is useful forthe protection of visual cells against light damage.

Non Patent Literature 4 teaches that oral administration ofgeranylgeranylacetone to a mouse with retinal injury induced by ischemiasignificantly increased the number of surviving retinal neurons and thatgeranylgeranylacetone is useful for the treatment of retinaldegenerative diseases that involve ischemic injury.

Non Patent Literature 5 teaches that oral administration ofgeranylgeranylacetone to a multiple sclerosis mouse model improved thevisual function, reduced the number of degenerating axons in the opticnerve, and prevented cell loss in the ganglion.

Teprenone marketed by Eisai Co., Ltd. is a mixture of(5E,9E,13E)-geranylgeranylacetone and (5Z,9E,13E)-geranylgeranylacetoneat a weight ratio of 3:2 (WO 2004/047822, JP-9-169639 A, JP Pat. No.4621326, JP-2006-89393 A, the Japanese pharmacopoeia, 16th edition, andthe package insert of Selbex). Hence geranylgeranylacetone described inPatent Literature 3 and Non Patent Literature 1 to 5 is also a mixtureof (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone at a weight ratio of 3:2. Teprenonemarketed by companies other than Eisai Co., Ltd. are also mixtures of(5E,9E,13E)-geranylgeranylacetone and (5Z,9E,13E)-geranylgeranylacetoneat a weight ratio of 3:2 (for example, see MSDS (Cat. No. 202-15733;Wako Pure Chemical Industries, Ltd.).

However, teprenone, which is a mixture of(5E,9E,13E)-geranylgeranylacetone and (5Z,9E,13E)-geranylgeranylacetoneat a weight ratio of 3:2, lacks a practically sufficient amelioratingeffect for a retinal disease.

CITATION LIST Patent Literature

-   Patent Literature 1: JP-8-133967 A-   Patent Literature 2: JP-2000-319170 A-   Patent Literature 3: JP-2009-507770 A

Non Patent Literature

-   Non Patent Literature 1: The American Journal of Pathology, Vol.    178, No. 3, March 2011, 1080-1090-   Non Patent Literature 2: Investigative Ophthalmology & Visual    Science, May 2003, Vol. 44, No. 5, 1982-1992-   Non Patent Literature 3: The Journal of Neuroscience, Mar. 2, 2005,    25(9), 2396-2404-   Non Patent Literature 4: Molecular vision, 2007, 13, 1601-1607-   Non Patent Literature 5: Neuroscience Letters, 462, 2009, 281-285

SUMMARY OF INVENTION Technical Problem

An object of the present invention is to provide a prophylactic,ameliorating or therapeutic agent having a practically sufficient effectfor a retinal disease.

Solution to Problem

The inventors conducted extensive research in order to solve the aboveproblem and found the following unexpected findings.

(i) Geranylgeranylacetone has a protective action for a retinal cell andis very effective in the prevention, amelioration and treatment of aretinal disease. The effect is high when(5E,9E,13E)-geranylgeranylacetone (hereinafter sometimes referred to as“all-trans form”) or (5Z,9E,13E)-geranylgeranylacetone (hereinaftersometimes referred to as “5Z-mono-cis form”) is used, whereas the effectis low when a mixture thereof is used.(ii) The all-trans form has a far superior protective effect for aretinal cell to teprenone, which is a mixture of the all-trans form andthe 5Z-mono-cis form at a weight ratio of 3:2.(iii) When the all-trans form content of a mixture of the all-trans formand the 5Z-mono-cis form is 80% by weight or more, the protective effectfor a retinal cell is significantly high.(iv) When the 5Z-mono-cis form content of a mixture of the all-transform and the 5Z-mono-cis form is very high, the protective effect for aretinal cell is also significantly high.

The present invention has been completed based on the above findings andprovides a prophylactic, ameliorating or therapeutic agent for a retinaldisease, as described below.

(1) A prophylactic, ameliorating or therapeutic agent for a retinaldisease, the agent comprising geranylgeranylacetone which

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone.

(2) The agent according to the above (1), which is an ophthalmicpreparation.

(3) The agent according to the above (2), wherein thegeranylgeranylacetone content is 0.00001 to 10% by weight relative tothe total amount of the preparation.

(4) The agent according to the above (1), which is an oral agent.

(5) The agent according to the above (4), wherein thegeranylgeranylacetone content is 0.001 to 80% by weight relative to thetotal amount of the preparation.

(6) The agent according to any of the above (1) to (5), wherein theretinal disease is a disease selected from the group consisting ofglaucoma, retinitis pigmentosa, age-related macular degeneration anddiabetic retinopathy.

(7) The agent according to any of the above (1) to (6), whose pH is from6 to 8.

(8) The agent according to any of the above (1) to (7), which furthercomprises a phosphate buffering agent.

(9) A protective agent for a retinal cell, the agent comprising as anactive ingredient geranylgeranylacetone which

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone.

(10) The agent according to the above (9), which is an ophthalmicpreparation.

(11) The agent according to the above (10), wherein thegeranylgeranylacetone content is 0.00001 to 10% by weight relative tothe total amount of the preparation.

(12) The agent according to the above (9), which is an oral agent.

(13) The agent according to the above (12), wherein thegeranylgeranylacetone content is 0.001 to 80% by weight relative to thetotal amount of the preparation.

(14) The agent according to any of the above (9) to (13), wherein theretinal cell is a retinal ganglion cell or a retinal pigment epithelialcell.

(15) The agent according to any of the above (9) to (14), whose pH isfrom 6 to 8.

(16) The agent according to any of the above (9) to (13), which furthercomprises a phosphate buffering agent.

(17) A suppressing agent for the degeneration, impairment or destructionof a retinal cell, the agent comprising as an active ingredientgeranylgeranylacetone which

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone.

(18) The agent according to the above (17), which is an ophthalmicpreparation.

(19) The agent according to the above (18), wherein thegeranylgeranylacetone content is 0.00001 to 10% by weight relative tothe total amount of the preparation.

(20) The agent according to the above (17), which is an oral agent.

(21) The agent according to the above (20), wherein thegeranylgeranylacetone content is 0.001 to 80% by weight relative to thetotal amount of the preparation.

(22) The agent according to any of the above (17) to (21), wherein theretinal cell is a retinal ganglion cell or a retinal pigment epithelialcell.

(23) The agent according to any of the above (17) to (22), whose pH isfrom 6 to 8.

(24) The agent according to any of the above (17) to (23), which furthercomprises a phosphate buffering agent.

(25) A composition for use in the prevention, amelioration or treatmentof a retinal disease, the composition comprising geranylgeranylacetonewhich

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone.

(26) Use of geranylgeranylacetone for the production of a prophylactic,ameliorating or therapeutic agent for a retinal disease, thegeranylgeranylacetone

(a) being a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consisting of (5E,9E,13E)-geranylgeranylacetone, or(c) consisting of (5Z,9E,13E)-geranylgeranylacetone.

(27) Use of geranylgeranylacetone as a prophylactic, ameliorating ortherapeutic agent for a retinal disease, the geranylgeranylacetone

(a) being a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consisting of (5E,9E,13E)-geranylgeranylacetone, or(c) consisting of (5Z,9E,13E)-geranylgeranylacetone.

(28) A method for preventing, ameliorating or treating a retinaldisease, the method comprising the step of administering to a patientwith a retinal disease an effective amount of geranylgeranylacetonewhich

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more, or(b) consists of (5E,9E,13E)-geranylgeranylacetone, thereby preventing,ameliorating or treating the retinal disease.

(29) A composition for use in the protection of a retinal cell, thecomposition comprising geranylgeranylacetone which

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone.

(31) Use of geranylgeranylacetone as a protective agent for a retinalcell, the geranylgeranylacetone

(a) being a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consisting of (5E,9E,13E)-geranylgeranylacetone, or(c) consisting of (5Z,9E,13E)-geranylgeranylacetone.

(30) Use of geranylgeranylacetone for the production of a protectiveagent for a retinal cell, the geranylgeranylacetone

(a) being a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consisting of (5E,9E,13E)-geranylgeranylacetone, or(c) consisting of (5Z,9E,13E)-geranylgeranylacetone.

(32) A method for protecting a retinal cell, the method comprising thestep of administering to a patient with a retinal disease an effectiveamount of geranylgeranylacetone which

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone, thereby protecting aretinal cell.

(33) A composition for use in the suppression of the degeneration,impairment or destruction of a retinal cell, the composition comprisinggeranylgeranylacetone which

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone.

(34) Use of geranylgeranylacetone for the production of a suppressingagent for the degeneration, impairment or destruction of a retinal cell,the geranylgeranylacetone

(a) being a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consisting of (5E,9E,13E)-geranylgeranylacetone, or(c) consisting of (5Z,9E,13E)-geranylgeranylacetone.

(35) Use of geranylgeranylacetone as a suppressing agent for thedegeneration, impairment or destruction of a retinal cell, thegeranylgeranylacetone

(a) being a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consisting of (5E,9E,13E)-geranylgeranylacetone, or(c) consisting of (5Z,9E,13E)-geranylgeranylacetone.

(36) A method for suppressing the degeneration, impairment ordestruction of a retinal cell, the method comprising the step ofadministering to a patient with a retinal disease an effective amount ofgeranylgeranylacetone which

(a) is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more,(b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone, thereby suppressingthe degeneration, impairment or destruction of a retinal cell.

Advantageous Effects of Invention

The agent of the present invention comprising geranylgeranylacetone(hereinafter sometimes abbreviated to “GGA”) having the all-trans formcontent of 80% by weight or more protects various types of retinal cellsfrom degeneration, impairment or destruction, thereby remarkablypromoting the survival. Consequently, the agent exhibits a remarkableeffect of preventing, ameliorating or treating various retinal diseases.

GGA having the all-trans form content of 80% by weight or more canexhibit the protective action for a retinal cell even in a small amount,and the agent of the present invention is therefore not required tocomprise a high level of GGA. In contrast, generally the components ofan ophthalmic preparation have poor penetration into the eyeball and arehence used at a relatively high concentration. Therefore, the fact thatthe agent of the present invention requires only a low level of GGA is agreat advantage as an ophthalmic preparation.

Conventional therapeutic agents for retinal diseases indirectly protectretinal cells through, for example, reduction in the intraocularpressure, thereby suppressing retinal neuronal cell death due to theelevation of intraocular pressure. In contrast, the agent of the presentinvention directly suppresses retinal cell death and thus fundamentallyprevents, ameliorates or treats a retinal disease. Therefore, the agentof the present invention is very useful as a therapeutic agent for aretinal disease.

In addition, since GGA has been widely used and the safety has beenestablished, the agent of the present invention is safe.

Further, the agent of the present invention can be formulated into adosage form that the patient can easily take at home, for example, aneye drop or an oral agent and is therefore useful as a prophylactic,ameliorating or therapeutic agent for a serious retinal disease.

A liquid preparation comprising teprenone, which is a mixture of theall-trans form and the 5Z-mono-cis form at a weight ratio of 3:2, tendsto become white turbid when stored at low temperature. Consequently,during commercial distribution to or during storage in cold areas, sucha liquid preparation becomes white turbid, which reduces its commercialvalue.

In this regard, the agent of the present invention comprising GGA havingthe all-trans form content of 80% by weight or more hardly becomes whiteturbid even when stored at low temperature. Therefore, the agent of thepresent invention can be commercially distributed to any area and thusits commercial value is high.

Further, an ophthalmic composition of the present invention comprisingGGA having the all-trans form content of 80% by weight or more exhibitsreduced eye irritancy.

Mono-cis-GGA and GGA that is a mixture of the all-trans form and themono-cis form and has a very high mono-cis form content also have aprotective action for a retinal cell and are very effective in theprevention, amelioration and treatment of a retinal disease. Theireffects are far superior to that of teprenone, which is a mixture of theall-trans form and the 5Z-mono-cis form at a weight ratio of 3:2.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 shows the cytoprotective effect of GGA against ischemic celldeath induced by hypoxia and low glucose.

FIG. 2 shows the neurite outgrowth inducing effect of GGA in rat RGC.

FIG. 3 is photographs showing the neurite outgrowth inducing effect ofGGA in rat RGC.

FIG. 4 shows the cytoprotective action of GGA against oxidative stress.

FIG. 5 shows the reducing effect of GGA on IL-8 production by TNF-α.

FIG. 6 shows the ocular neuroprotective actions of the all-trans formand the 5Z-mono-cis form in rat models with glaucoma induced by NMDA.

FIG. 7 shows the ocular neuroprotective action of the all-trans form inrat models with glaucoma induced by NMDA.

FIG. 8 shows increase in the thickness of the inner plexiform layer ofthe retina by the all-trans form in rat models with glaucoma induced byNMDA.

FIG. 9 shows the ocular neuroprotective action of the all-trans form inrat models with glaucoma induced by NMDA.

FIG. 10 shows the effect of reducing white turbidity during storage atlow temperature, observed in a GGA-containing ophthalmic composition.

DESCRIPTION OF EMBODIMENTS

The present invention will be described in detail below.

A prophylactic, ameliorating or therapeutic agent for a retinal diseaseof the present invention comprises GGA as an active ingredient.

GGA herein is entirely in the all-trans form; entirely in the mono-cisform; a mixture of the all-trans form and the mono-cis form, the mixturehaving the all-trans form content of 80% by weight or more; or a mixtureof the all-trans form and the mono-cis form, the mixture having a veryhigh mono-cis form content.

Geranylgeranylacetone (1) Types of Geometric Isomers

GGA has eight geometric isomers. Specifically, the eight geometricisomers are:

-   (5E,9E,13E)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5E,9E,13E GGA) (all-trans form),-   (5Z,9E,13E)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5Z,9E,13E GGA) (5Z-mono-cis form),-   (5Z,9Z,13E)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5Z,9Z,13E GGA) (13E-mono-trans form),-   (5Z,9Z,13Z)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5Z,9Z,13Z GGA) (all-cis form),-   (5E,9Z,13E)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5E,9Z,13E GGA) (9Z-mono-cis form),-   (5E,9Z,13Z)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5E,9Z,13Z GGA) (5E-mono-trans form),-   (5E,9E,13Z)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5E,9E,13Z GGA) (13Z-mono-cis form), and-   (5Z,9E,13Z)-6,10,14,18-tetramethyl-5,9,13,17-nonadecatetrae n-2-one    (5Z,9E,13Z GGA) (9E-mono-trans form).

In the present invention, GGA consists of the all-trans form, consistsof the mono-cis form, or is a mixture of the all-trans form and themono-cis form. The mono-cis form may be any of the 5Z-mono-cis form, the9Z-mono-cis form, and the 13Z-mono-cis form, or a combination of two ormore thereof.

Preferably the mono-cis form is the 5Z-mono-cis form.

In cases where GGA is a mixture of the all-trans form and the mono-cisform (in particular the 5Z-mono-cis form), the all-trans form content ofthe mixture is 80% by weight or more, preferably 82% by weight or more,more preferably 84% by weight or more, further more preferably 86% byweight or more, further more preferably 88% by weight or more, furthermore preferably 90% by weight or more, further more preferably 92% byweight or more, further more preferably 94% by weight or more, furthermore preferably 96% by weight, further more preferably 98% by weight ormore. Especially preferably, GGA consists of the all-trans form. Themixture having the all-trans form content in the above ranges exhibits aremarkable effect of preventing, ameliorating or treating a retinaldisease and hardly becomes white turbid when stored at low temperature.

A mixture of the all-trans form and the mono-cis form (in particular the5Z-mono-cis form) with a very high mono-cis form (in particular the5Z-mono-cis form) ratio is also preferred due to its remarkableprophylactic, ameliorating or therapeutic effect for a retinal disease.

(2) All-Trans Form and 5Z-Mono-Cis Form

(5E,9E,13E)-geranylgeranylacetone (the all-trans form) is a compoundrepresented by the following structural formula:

The all-trans form can be purchased from, for example, RionlonDevelopment Co., Ltd.

The all-trans form can also be obtained through separating the all-transform and the 5Z-mono-cis form of a marketed teprenone (Eisai Co., Ltd.,Wako Pure Chemical Industries, Ltd., Yoshindo Inc., etc.) by, forexample, silica gel chromatography using a mobile phase ofn-hexane/ethyl acetate (9:1). The separation of the all-trans form andthe 5Z-mono-cis form of a marketed teprenone can also be commissionedto, for example, KNC Laboratories Co., Ltd.

(5Z,9E,13E)-geranylgeranylacetone (the 5Z-mono-cis form) can also beobtained by the separation from a marketed teprenone. The 5Z-mono-cisform is a compound represented by the following structural formula:

The all-trans form can also be synthesized in accordance with a methoddescribed in, for example, Bull. Korean Chem. Soc., 2009, Vol. 30, No.9, 215-217. This literature describes, for example, the method shown bythe following synthesis scheme:

Specifically, in the above reaction formula, geranyllinalool 1 is mixedwith Compound 2 and aluminum isopropoxide, and the mixture is graduallyheated to 130° C. to allow the reaction to occur. After the completionof the reaction, the residue Compound 2 is removed and the reactionmixture is diluted with 5%; sodium carbonate so that the residuealuminum propoxide is quenched. In this way, the all-trans form can beobtained. The obtained all-trans form is subsequently purified by, forexample, silica gel chromatography using dichloromethane as an eluent.

(3) Mixtures of all-Trans Form and 5Z-Mono-Cis Form

Mixtures of the all-trans form and the 5Z-mono-cis form can be obtainedby adding the all-trans form or the 5Z-mono-cis form to a marketedteprenone.

Preparations

The dosage form of the agent of the present invention is notparticularly limited and any known pharmaceutical dosage form can beemployed without limitation. Examples thereof include an ophthalmicagent, an oral agent, an injection (an intravenous injection, ahypodermic injection, an intramuscular injection, etc.), a percutaneousabsorption agent, a suppository, and inhalant. Among these, preferredare an ophthalmic agent, an oral agent, or a percutaneous absorptionagent and more preferred is an ophthalmic agent in terms of theeffectiveness as a prophylactic, ameliorating or therapeutic agent for aretinal disease and the easiness of use for the patient.

The preparation in any of these dosage forms can comprise, in additionto GGA, a pharmaceutically acceptable base or carrier, apharmaceutically acceptable additive, and/or a physiologically orpharmacologically active component other than GGA.

(1) Ophthalmic Agent

The form of an ophthalmic agent is not particularly limited and may bein any form such as a liquid, a fluid, a gel, a semi-solid, and a solid.

The type of the ophthalmic agent is not particularly limited. Examplesthereof include an eye drop, an eye wash, a contact lens-wearingsolution, a contact lens solution (e.g., a washing solution, a storagesolution, a sterilizing solution, a multipurpose solution, a packagesolution, etc.), a preservative for a harvested ocular tissue (a corneaetc.) for transplantation, an irrigating solution for surgery, anophthalmic ointment (e.g., a water-soluble ophthalmic ointment, anoil-soluble ophthalmic ointment, etc.), an intraocular injection (e.g.,an intravitreal injection), etc.

The ophthalmic agent in the form other than a solid, for example, aliquid, a fluid, a gel, or a semi-solid or the ophthalmic agent in asolid form may be an aqueous composition or an oil composition such asan ointment.

Preparation methods for an ophthalmic preparation are well known. Anophthalmic preparation can be prepared by mixing GGA with apharmaceutically acceptable base or carrier, and as needed apharmaceutically acceptable additive for an ophthalmic preparation andanother active ingredient (a physiologically or pharmacologically activecomponent).

<Bases or Carriers>

Examples of the base or carrier include water; an aqueous solvent suchas a polar solvent; a polyalcohol; a vegetable oil; and an oily base.Examples of the base or carrier for an intraocular injection includewater for injection and physiological saline.

These bases or carriers can be used alone or in combination of two ormore thereof.

<Additives>

Examples of the additive include a surfactant, a flavor or coolingagent, an antiseptic, a bactericide or antibacterial agent, a pHadjusting agent, a tonicity agent, a chelating agent, a buffering agent,a stabilizer, an antioxidant, and a thickening agent. An intraocularinjection may contain a solubilizing agent, a suspending agent, atonicity agent, a buffering agent, a soothing agent, a stabilizer, andan antiseptic.

These additives can be used alone or in combination of two or morethereof.

The additives will be exemplified below.

Surfactants: for example, nonionic surfactants such as polyoxyethylene(hereinafter sometimes referred to as “POE”)-polyoxypropylene(hereinafter sometimes referred to as “POP”) block copolymers (e.g.,poloxamer 407, poloxamer 235, poloxamer 188), ethylenediamine POE-POPblock copolymer adducts (e.g., poloxamine), POE sorbitan fatty acidesters (e.g., polysorbate 20, polysorbate 60, polysorbate 80 (TO-10etc.)), POE hydrogenated castor oils (e.g., POE (60) hydrogenated castoroil (HCO-60 etc.)), POE castor oils, POE alkyl ethers (e.g.,polyoxyethylene (9) lauryl ether, polyoxyethylene (20) polyoxypropylene(4) cetyl ether), and polyoxyl stearate;

amphoteric surfactants such as glycine-type amphoteric surfactants(e.g., alkyl diaminoethyl glycine, alkyl polyaminoethyl glycine),betaine-type amphoteric surfactants (e.g., lauryldimethylaminoaceticbetaine, imidazolinium betaine);cationic surfactants such as alkyl quaternary ammonium salts (e.g.,benzalkonium chloride, benzethonium chloride); etc.

The numbers in the parentheses represent the molar number of added POEor POP.

Flavors or cooling agents: for example, camphor, borneol, terpenes(these may be in the d-form, l-form, or dl-form); essential oils such asmentha water, eucalyptus oil, bergamot oil, anethole, eugenol, geraniol,menthol, limonene, mentha oil, peppermint oil, rose oil, etc.

Antiseptics, bactericides, or antibacterial agents: for example,polidronium chloride, alkyldiaminoethylglycine hydrochloride, sodiumbenzoate, ethanol, benzalkonium chloride, benzethonium chloride,chlorhexidine gluconate, chlorobutanol, sorbic acid, potassium sorbate,sodium dehydroacetate, methyl paraoxybenzoate, ethyl paraoxybenzoate,propyl paraoxybenzoate, butyl paraoxybenzoate, oxyquinoline sulfate,phenethyl alcohol, benzyl alcohol, biguanide compounds (in particular,polyhexamethylene biguanide or its hydrochloride etc.), Glokill (RhodiaLtd.), etc.

pH adjusting agents: for example, hydrochloric acid, sodium hydroxide,potassium hydroxide, calcium hydroxide, magnesium hydroxide,triethanolamine, monoethanolamine, diisopropanolamine, sulfuric acid,phosphoric acid, etc.

Tonicity agents: for example, sodium bisulfite, sodium sulfite,potassium chloride, calcium chloride, sodium chloride, magnesiumchloride, potassium acetate, sodium acetate, sodium bicarbonate, sodiumcarbonate, sodium thiosulfate, magnesium sulfate, disodium hydrogenphosphate, sodium dihydrogen phosphate, potassium dihydrogen phosphate,glycerin, propylene glycol, etc.

Chelating agents: for example, ascorbic acid, edetic acid tetrasodium,sodium edetate, citric acid, etc.

Buffering agents: for example, phosphate buffering agents; citratebuffering agents such as citric acid and sodium citrate; acetatebuffering agents such as acetic acid, potassium acetate, and sodiumacetate; carbonate buffering agents such as sodium bicarbonate andsodium carbonate; borate buffering agents such as boric acid and borax;amino acid buffering agents such as taurine, aspartic acid and its salts(e.g., potassium salts etc.), and ε-aminocaproic acid; etc.

Among the above, phosphate buffering agents are preferred for pHadjustment and the use of a phosphate buffering agent reduces adsorptionof GGA to a container wall, thereby reducing the loss of the GGA contentof the ophthalmic agent. The use of a phosphate buffering agent alsoreduces white turbidity during storage at low temperature, reducesadsorption of GGA to a contact lens, and improves the thermal and lightstabilities.

The phosphate buffering agents can be used alone or in combination oftwo or more thereof.

The phosphate buffering agent is not particularly limited and examplesthereof include phosphoric acid; alkali metal phosphates such asdisodium hydrogen phosphate, sodium dihydrogen phosphate, trisodiumphosphate, dipotassium hydrogen phosphate, potassium dihydrogenphosphate, and tripotassium phosphate; alkaline earth metal phosphatessuch as calcium phosphate, calcium hydrogen phosphate, calciumdihydrogen phosphate, monomagnesium phosphate, dimagnesium phosphate(magnesium hydrogen phosphate), and trimagnesium phosphate; and ammoniumphosphates such as diammonium hydrogen phosphate and ammonium dihydrogenphosphate. The phosphate buffering agent may be an anhydride or hydrate.

Among the above, preferably at least one selected from the groupconsisting of phosphoric acid and alkali metal phosphates is used, andmore preferably at least one selected from the group consisting ofphosphoric acid and sodium phosphates is used.

Preferred combinations of phosphate buffering agents are, for example, acombination of phosphoric acid, disodium hydrogen phosphate, sodiumdihydrogen phosphate, and trisodium phosphate; a combination ofphosphoric acid, disodium hydrogen phosphate, and sodium dihydrogenphosphate; a combination of phosphoric acid, disodium hydrogenphosphate, and trisodium phosphate; a combination of phosphoric acid,sodium dihydrogen phosphate, and trisodium phosphate; a combination ofdisodium hydrogen phosphate, sodium dihydrogen phosphate, and trisodiumphosphate; a combination of phosphoric acid and disodium hydrogenphosphate; a combination of phosphoric acid and sodium dihydrogenphosphate; a combination of phosphoric acid and trisodium phosphate; acombination of disodium hydrogen phosphate and sodium dihydrogenphosphate; a combination of disodium hydrogen phosphate and trisodiumphosphate; and a combination of sodium dihydrogen phosphate andtrisodium phosphate.

Among these, preferred are a combination of phosphoric acid, disodiumhydrogen phosphate, and sodium dihydrogen phosphate; a combination ofphosphoric acid and disodium hydrogen phosphate; a combination ofphosphoric acid and sodium dihydrogen phosphate; and a combination ofdisodium hydrogen phosphate and sodium dihydrogen phosphate. Morepreferred is a combination of disodium hydrogen phosphate and sodiumdihydrogen phosphate.

The phosphate buffering agent content expressed in terms of acorresponding anhydride is preferably 0.001% by weight or more, morepreferably 0.005% by weight or more, further more preferably 0.01% byweight or more, further more preferably 0.05% by weight or more,relative to the total amount of the ophthalmic agent. The phosphatebuffering agent in the above ranges is sufficient to exhibit the effectsof stabilizing GGA, reducing white turbidity at low temperature, andreducing adsorption of GGA to a container wall or a contact lens.

The phosphate buffering agent content of the ophthalmic agent expressedin terms of a corresponding anhydride is preferably 10% by weight orless, more preferably 7% by weight or less, further more preferably 5%by weight or less, further more preferably 3% by weight or less,relative to the total amount of the ophthalmic agent. When GGA is in theabove ranges, the ophthalmic agent exhibits reduced eye irritancy.

The phosphate buffering agent content expressed in terms of acorresponding anhydride is, for example, about 0.001 to 10% by weight,about 0.001 to 7% by weight, about 0.001 to 5% by weight, about 0.001 to3% by weight, about 0.005 to 10% by weight, about 0.005 to 7% by weight,about 0.005 to 5% by weight, about 0.005 to 3% by weight, about 0.01 to10% by weight, about 0.01 to 7% by weight, about 0.01 to 5% by weight,about 0.01 to 3% by weight, about 0.05 to 10% by weight, about 0.05 to7% by weight, about 0.05 to 5% by weight, or about 0.05 to 3% by weight,relative to the total amount of the ophthalmic agent.

The phosphate buffering agent content expressed in terms of acorresponding anhydride is preferably 0.0005 parts by weight or more,more preferably 0.001 parts by weight or more, further more preferably0.005 parts by weight or more, further more preferably 0.01 parts byweight or more, relative to 1 part by weight of GGA. The phosphatebuffering agent in the above ranges is sufficient to exhibit the effectsof stabilizing GGA, reducing white turbidity at low temperature, andreducing adsorption of GGA to a container wall or a contact lens.

The phosphate buffering agent content expressed in terms of acorresponding anhydride is preferably 5000 parts by weight or less, morepreferably 1000 parts by weight or less, further more preferably 500parts by weight or less, further more preferably 200 parts by weight orless, relative to 1 part by weight of GGA. When the phosphate bufferingagent is in the above ranges, the ophthalmic agent exhibits reduced eyeirritancy.

The phosphate buffering agent content expressed in terms of acorresponding anhydride is, for example, about 0.0005 to 5000 parts byweight, about 0.0005 to 1000 parts by weight, about 0.0005 to 500 partsby weight, about 0.0005 to 200 parts by weight, about 0.001 to 5000parts by weight, about 0.001 to 1000 parts by weight, about 0.001 to 500parts by weight, about 0.001 to 200 parts by weight, about 0.005 to 5000parts by weight, about 0.005 to 1000 parts by weight, about 0.005 to 500parts by weight, about 0.005 to 200 parts by weight, about 0.01 to 5000parts by weight, about 0.01 to 1000 parts by weight, about 0.01 to 500parts by weight, or about 0.01 to 200 parts by weight, relative to 1part by weight of GGA.

Stabilizers: for example, trometamol, sodium formaldehyde sulfoxylate(rongalit), tocopherol, sodium pyrosulfite, monoethanolamine, aluminummonostearate, glyceryl monostearate, etc.

Antioxidants: for example, water-soluble antioxidants such as ascorbicacid, ascorbic acid derivatives (ascorbic acid-2-sulfate disodium salts,sodium ascorbate, ascorbic acid-2-magnesium phosphate, ascorbicacid-2-sodium phosphate, etc.), sodium bisulfite, sodium sulfite, sodiumthiosulfate, etc.

The ophthalmic agent may comprise a fat-soluble antioxidant and the useof a fat-soluble antioxidant reduces adsorption of the ophthalmic agentto a container wall, thereby reducing the loss of the GGA content of thecomposition. The use of a fat-soluble antioxidant also reducesadsorption of GGA to a contact lens, and improves the thermal and lightstabilities of GGA.

Examples of the fat-soluble antioxidant include butyl group-containingphenols such as butylhydroxytoluene (BHT) and butylhydroxyanisole (BHA);nordihydroguaiaretic acid (NDGA); ascorbic acid esters such as ascorbylpalmitate, ascorbyl stearate, ascorbyl aminopropyl phosphate, ascorbyltocopherol phosphate, ascorbic acid triphosphate, and ascorbyl palmitatephosphate; tocopherols such as α-tocopherol, β-tocopherol, γ-tocopherol,and δ-tocopherol; tocopherol derivatives such as tocopherol acetate,tocopherol nicotinate, and tocopherol succinate; gallic acid esters suchas ethyl gallate, propyl gallate, octyl gallate, and dodecyl gallate;propyl gallate; 3-butyl-4-hydroxyquinolin-2-one; vegetable oils such assoybean oil, rapeseed oil, olive oil, and sesame oil; carotenoids suchas lutein and astaxanthin; polyphenols such as anthocyanins, catechin,tannin, and curcumin; the vitamin A group including retinol, retinolesters (retinol acetate, retinol propionate, retinol butyrate, retinoloctylate, retinol laurate, retinol stearate, retinol myristate, retinololeate, retinol linolenate, retinol linoleate, retinol palmitate, etc.),retinal, retinal esters (retinal acetate, retinal propionate, retinalpalmitate, etc.), retinoic acid, retinoic acid esters (methyl retinoate,ethyl retinoate, retinol retinoate, tocopheryl retinoate, etc.), dehydroforms of retinol, dehydro forms of retinal, dehydro forms of retinoicacid, provitamin A (α-carotene, β-carotene, γ-carotene, δ-carotene,lycopene, zeaxanthin, β-cryptoxanthin, echinenone, etc.), and vitamin A;CoQ10 etc. These compounds are marketed.

Among these, preferred are butyl group-containing phenols, NDGA,ascorbic acid esters, tocopherols, tocopherol derivatives, gallic acidesters, propyl gallate, and 3-butyl-4-hydroxyquinol in-2-one, vegetableoils, and the vitamin A group. Among these, preferred are butylgroup-containing phenols, tocopherols, tocopherol derivatives, vegetableoils, and the vitamin A group, more preferred are butyl group-containingphenols, vegetable oils, retinol, and retinol esters, and further morepreferred are BHT, BHA, sesame oil, and retinol palmitate.

These fat-soluble antioxidants can be used alone or in combination oftwo or more thereof.

The fat-soluble antioxidant content of the ophthalmic agent ispreferably 0.00001% by weight or more, more preferably 0.00005% byweight or more, further more preferably 0.0001% by weight or more,further more preferably 0.0005% by weight or more, relative to the totalamount of the ophthalmic agent. The fat-soluble antioxidant in the aboveranges is sufficient to exhibit the effects of reducing adsorption ofGGA to a container wall (thereby reducing the loss of the GGA content),reducing adsorption of GGA to a contact lens, and improving the thermaland light stabilities of GGA.

The fat-soluble antioxidant content of the ophthalmic agent ispreferably 10% by weight or less, more preferably 5% by weight or less,further more preferably 2% by weight or less, further more preferably 1%by weight or less, relative to the total amount of the composition. Whenthe fat-soluble antioxidant is in the above ranges, the ophthalmic agentexhibits reduced eye irritancy.

The fat-soluble antioxidant content of the ophthalmic agent is, forexample, about 0.00001 to 10% by weight, about 0.00001 to 5% by weight,about 0.00001 to 2% by weight, about 0.00001 to 1% by weight, about0.00005 to 10% by weight, about 0.00005 to 5% by weight, about 0.00005to 2% by weight, about 0.00005 to 1% by weight, about 0.0001 to 10% byweight, about 0.0001 to 5% by weight, about 0.0001 to 2% by weight,about 0.0001 to 1% by weight, about 0.0005 to 10% by weight, about0.0005 to 5% by weight, about 0.0005 to 2% by weight, or about 0.0005 to1% by weight, relative to the total amount of the ophthalmic agent.

The fat-soluble antioxidant content of the ophthalmic agent ispreferably 0.0001 parts by weight or more, more preferably 0.001 partsby weight or more, further more preferably 0.005 parts by weight ormore, further more preferably 0.01 parts by weight or more, relative to1 part by weight of GGA. The fat-soluble antioxidant in the above rangesis sufficient to exhibit the effects of reducing adsorption of GGA to acontainer wall (thereby reducing the loss of the GGA content), reducingadsorption of GGA to a contact lens, and improving the thermal and lightstabilities of GGA.

The fat-soluble antioxidant content of the ophthalmic agent ispreferably 100 parts by weight or less, more preferably 50 parts byweight or less, further more preferably 10 parts by weight or less,further more preferably 5 parts by weight or less, relative to 1 part byweight of GGA. When the fat-soluble antioxidant is in the above ranges,the ophthalmic agent exhibits reduced eye irritancy.

The fat-soluble antioxidant content of the ophthalmic agent is, forexample, about 0.0001 to 100 parts by weight, about 0.0001 to 50 partsby weight, about 0.0001 to 10 parts by weight, about 0.0001 to 5 partsby weight, about 0.001 to 100 parts by weight, about 0.001 to 50 partsby weight, about 0.001 to 10 parts by weight, about 0.001 to 5 parts byweight, about 0.005 to 100 parts by weight, about 0.005 to 50 parts byweight, about 0.005 to 10 parts by weight, about 0.005 to 5 parts byweight, about 0.01 to 100 parts by weight, about 0.01 to 50 parts byweight, about 0.01 to 10 parts by weight, or about 0.01 to 5 parts byweight, relative to 1 part by weight of GGA.

Thickening agents: for example, guar gum; hydroxypropyl guar gum; highmolecular cellulose compounds such as methylcellulose, ethylcellulose,hydroxypropyl methylcellulose, hydroxyethyl cellulose, and carboxymethylcellulose sodium; gum arabic; karaya gum; xanthan gum; agar-agar;alginic acid; a-cyclodextrin; dextrin; dextran; heparin; heparinoid;heparin sulfate; heparan sulfate; hyaluronic acid; hyaluronates (sodiumsalts etc.); sodium chondroitin sulfate; starch; chitin and itsderivatives; chitosan and its derivatives; carrageenan; sorbitol; highmolecular polyvinyl compounds such as polyvinylpyrrolidone, polyvinylalcohol, and polyvinyl methacrylate; carboxy vinyl polymers such asalkali metal polyacrylates (sodium salts, potassium salts, etc.), aminepolyacrylates (monoethanolamine salts, diethanolamine salts,triethanolamine salts, etc.), and ammonium polyacrylates; casein;gelatin; collagen; pectin; elastin; ceramide; liquid paraffin; glycerin;polyethylene glycol; macrogol; polyethyleneimine alginates (sodium saltsetc.); alginate esters (propylene glycol esters etc.); powderedtragacanth; triisopropanolamine; etc.

<Other Prophylactic, Ameliorating or Therapeutic Components for RetinalDiseases>

Preferably the ophthalmic agent comprises, in addition to GGA, acomponent that prevents or treats a retinal disease with a differentmechanism of action from that of GGA. That is, the ophthalmic agentpreferably comprises a combination of GGA and another component asactive ingredients for preventing, ameliorating or treating a retinaldisease. Such components that prevent or treat a retinal disease with adifferent mechanism of action from that of GGA can be used alone or incombination of two or more thereof.

Examples of such a combination include, but are not limited to,combinations of GGA and a prostaglandin F2α derivative, such ascombinations of GGA and a prost drug (GGA and latanoprost, GGA andtravoprost, GGA and tafluprost, etc.), combinations of GGA and aprostamide drug (GGA and bimatoprost, etc.), and combinations of GGA anda prostone drug (GGA and isopropyl unoprostone); combinations of GGA anda sympatholytic agent such as, combinations of GGA and a β-blocker (GGAand timolol maleate, GGA and gel-forming timolol, GGA and carteololhydrochloride, GGA and gel-forming carteolol, etc.), combinations of GGAand a β1-blocker (GGA and betaxolol hydrochloride, etc.), combinationsof GGA and an αβ-blocker (GGA and levobunolol hydrochloride, GGA andnipradilol, GGA and bunazosin hydrochloride, etc.), and combinations ofGGA and an α2-blocker (GGA and brimonidine tartrate); combinations ofGGA and a parasympathomimetic drug, such as GGA and pilocarpinehydrochloride, and GGA and distigmine bromide; combinations of GGA and asympathomimetic drug, such as GGA and epinephrine, GGA and epinephrinebitartrate, and GGA and dipivefrin hydrochloride; combinations of GGAand a carbonic anhydrase inhibitor, such as GGA and dorzolamidehydrochloride, and GGA and brinzolamide; combinations of GGA and aspecific inhibitor to ROCK (Rho-associated coiled coil forming proteinkinase), such as GGA and SNJ-1656, and GGA and K-115; combinations ofGGA and a calcium antagonist, such as GGA and lomerizine hydrochloride;combinations of GGA and an EP2 agonist, such as GGA and DE-117;combinations of GGA and an adenosine A2a receptor agonist, such as GGAand OPA-6566; combinations of GGA and a therapeutic agent forage-related macular degeneration, such as combinations of GGA and a VEGFaptamer (GGA and pegaptanib sodium) and combinations of GGA and a VEGFinhibitor (GGA and ranibizumab, and GGA and bevacizumab).

Among these, preferred are combinations of GGA and a prostaglandin F2αderivative and combinations of GGA and a sympatholytic drug (especiallypreferred are combinations of GGA and a β-blocker) because thesecombinations exhibit a very high prophylactic, ameliorating ortherapeutic effect for a retinal disease.

<Other Pharmacologically or Physiologically Active Components>

The ophthalmic agent can comprise a pharmacologically or physiologicallyactive component other than the prophylactic, ameliorating ortherapeutic component for a retinal disease. Such pharmacologically orphysiologically active components can be used alone or in combination oftwo or more thereof.

Examples of the pharmacologically or physiologically active componentsinclude nerve growth factors, decongestants, drugs for restoringextraocular muscle function, anti-inflammatory drugs or astringentdrugs, antihistaminics or antiallergics, vitamins, amino acids,antibacterial drugs or bactericides, sugars, high molecular compounds,celluloses or their derivatives, local anesthetics, etc. These drugswill be exemplified below.

Nerve growth factors: for example, nerve growth factor (NGF),brain-derived nerve growth factor (BDNF), glial cell line-derivedneurotrophic factor (GDNF), etc.

Since nutritional factors including nerve growth factors are containedin serum, it is possible to add serum from a patient to a preparationfor the patient.

Decongestants: for example, α-adrenergic agonists such as epinephrine,epinephrine hydrochloride, ephedrine hydrochloride, oxymetazolinehydrochloride, tetrahydrozoline hydrochloride, naphazolinehydrochloride, phenylephrine hydrochloride, methylephedrinehydrochloride, epinephrine hydrogen tartrate, naphazoline nitrate, etc.These may be in the d-form, l-form, or dl-form.

Drugs for restoring extraocular muscle function: for example,cholinesterase inhibitors having an active center similar to that ofacetylcholine, such as neostigmine methylsulfate, tropicamide, helenien,atropine sulfate, etc.

Anti-inflammatory drugs or astringent drugs: for example, zinc sulfate,zinc lactate, allantoin, ε-aminocaproic acid, indomethacin, lysozymechloride, silver nitrate, pranoprofen, azulene sulfonate sodium,dipotassium glycyrrhizinate, diammonium glycyrrhizinate, diclofenacsodium, bromfenac sodium, berberine chloride, berberine sulfate, etc.

Antihistaminics or antiallergics: for example, acitazanolast,diphenhydramine or its salts (hydrochloride etc.), chlorpheniraminemaleate, ketotifen fumarate, levocabastine or its salts (hydrochlorideetc.), amlexanox, ibudilast, tazanolast, tranilast, oxatomide, suplatastor its salts (tosilate etc.), sodium cromoglicate, pemirolast potassium,etc.

Vitamins: for example, retinol acetate, retinol palmitate, pyridoxinehydrochloride, flavin adenine dinucleotide sodium, pyridoxal phosphate,cyanocobalamin, panthenol, calcium pantothenate, sodium pantothenate,ascorbic acid, tocopherol acetate, tocopherol nicotinate, tocopherolsuccinate, tocopherol calcium succinate, ubiquinone derivatives, etc.

Amino acids: for example, aminoethylsulfonic acid (taurine), glutamicacid, creatinine, sodium aspartate, potassium aspartate, magnesiumaspartate, magnesium potassium aspartate, sodium glutamate, magnesiumglutamate, ε-aminocaproic acid, glycine, alanine, arginine, lysine,γ-aminobutyric acid, γ-aminovaleric acid, sodium chondroitin sulfate,etc. These may be in the d-form, l-form, or dl-form.

Antibacterial drugs or bactericides: for example,alkylpolyaminoethylglycine, chloramphenicol, sulfamethoxazole,sulfisoxazole, sulfamethoxazole sodium, sulfisoxazole diethanolamine,sulfisoxazole monoethanolamine, sulfisomezole sodium, sulfisomidinesodium, ofloxacin, norfloxacin, levofloxacin, lomefloxacinhydrochloride, acyclovir, etc.

Sugars: for example, monosaccharides, disaccharide, in particular,glucose, maltose, trehalose, sucrose, cyclodextrin, xylitol, sorbitol,mannitol, etc.

High molecular compounds: for example, alginic acid, sodium alginate,dextrin, dextran, pectin, hyaluronic acid, chondroitin sulfate,(completely or partially saponified) polyvinyl alcohol,polyvinylpyrrolidone, carboxy vinyl polymers, macrogol, pharmaceuticallyacceptable salts thereof, etc.

Celluloses or their derivatives: for example, ethylcellulose,hydroxyethyl cellulose, hydroxypropyl cellulose, hydroxypropylmethylcellulose, methylcellulose, carboxymethyl cellulose,carboxymethylcellulose sodium, carboxyethyl cellulose, nitrocellulose,etc.

Local anesthetics: for example, chlorobutanol, procaine hydrochloride,lidocaine hydrochloride, etc.

<GGA Content>

In the case of the ophthalmic preparation in the form other than asolid, for example, a liquid, a fluid, a gel, or a semi-solid, the GGAcontent of the ophthalmic composition is preferably 0.00001% by weightor more, more preferably 0.0001% by weight or more, further morepreferably 0.001% by weight or more, relative to the total amount of thecomposition. The GGA content may be 0.01% by weight or more, 0.1% byweight or more, or 1% by weight or more. GGA in the above ranges issufficient to exhibit the prophylactic, ameliorating or therapeuticeffect for a retinal disease.

In the above case of the ophthalmic preparation in the form other than asolid, for example, a liquid, a fluid, a gel, or a semi-solid, the GGAcontent of the ophthalmic composition is preferably 10% by weight orless, more preferably 5% by weight or less, further more preferably 3%by weight or less, relative to the total amount of the composition. GGAin the above ranges is sufficient to exhibit the prophylactic,ameliorating or therapeutic effect for a retinal disease, and theophthalmic preparation comprising GGA in the above ranges allows clearvision and hardly causes blurred vision.

In the above case of the ophthalmic preparation in the form other than asolid, for example, a liquid, a fluid, a gel, or a semi-solid, the GGAcontent of the ophthalmic composition is, for example, about 0.00001 to10% by weight, about 0.00001 to 5% by weight, about 0.00001 to 3% byweight, about 0.0001 to 10% by weight, about 0.0001 to 5% by weight,about 0.0001 to 3% by weight, about 0.001 to 10% by weight, about 0.001to 5% by weight, about 0.001 to 3% by weight, about 0.01 to 10% byweight, about 0.01 to 5% by weight, about 0.01 to 3% by weight, about0.1 to 10% by weight, about 0.1 to 5% by weight, about 0.1 to 3% byweight, about 1 to 10% by weight, about 1 to 5% by weight, or about 1 to3% by weight, relative to the total amount of the composition.

The GGA content of a solid preparation such as a sustained-releaseintraocular implant preparation and a sustained-release contact lenspreparation impregnated with GGA will be described later.

pH

When the ophthalmic agent is a composition containing moisture, the pHof the ophthalmic agent is preferably 4 or higher, more preferably 5.5or higher, further more preferably 6 or higher, further more preferably6.5 or higher. The preparation having a pH value in the above ranges isexcellent in the thermal and light stabilities of GGA.

The pH of the ophthalmic agent is preferably 9 or lower, more preferably8.5 or lower, further more preferably 8 or lower, further morepreferably 7.5 or lower. The ophthalmic agent having a pH value in theabove ranges exhibits reduced eye irritancy.

Sustained-Release Intraocular Implant

A sustained-release intraocular implant is another example of theophthalmic agent. Such a sustained-release intraocular implant can beprepared by various known preparation methods. The sustained-releaseintraocular implant prepared by known methods are, for example, a matrixpreparation prepared by mixing GGA with a carrier containing a highmolecular material and forming the mixture into a particular shape, apreparation prepared by coating a core containing GGA with a highmolecular membrane, a capsule preparation prepared by filling GGA into aminute capsule made of a high molecular material, etc.

As the high molecular material, any high molecular material can be usedwithout limitation as long as it is usually used for a sustained-releaseintraocular implant. Examples of such a high molecular material includehydroxypropyl cellulose, hydroxypropyl methylcellulose, hydroxypropylmethylcellulose phthalate, pullulan, gelatin, collagen, atelocollagen,hyaluronic acid, casein, agar-agar, gum arabic, dextrin, ethylcellulose,methylcellulose, chitin, chitosan, mannan, carboxy methyl ethylcellulose, carboxymethyl cellulose sodium, polyethylene glycol, sodiumalginate, polyvinyl alcohol, cellulose acetate, polyvinylpyrrolidone,silicone, polyvinyl acetal diethylamino acetate, albumin, lacticacid-glycolic acid copolymers, etc.

These high molecular materials can be used alone or in combination oftwo or more thereof.

Preferably the sustained-release intraocular implant comprises GGA andanother prophylactic, ameliorating or therapeutic component for aretinal disease. Such a combination is exemplified above. Thesustained-release intraocular implant can further comprise anotherpharmacologically or physiologically active component. Such a componentis exemplified above.

The GGA content of the sustained-release intraocular implant ispreferably 0.001 mg or more, more preferably 0.01 mg or more, furthermore preferably 0.1 mg or more, relative to the total amount of thepreparation. The GGA content is preferably 1000 mg or less, morepreferably 100 mg or less, further more preferably 10 mg or less. GGA inthe above ranges is sufficient to exhibit the prophylactic, amelioratingor therapeutic effect for a retinal disease.

The GGA content of the sustained-release intraocular implant is, forexample, about 0.001 to 1000 mg, about 0.001 to 100 mg, about 0.001 to10 mg, about 0.01 to 1000 mg, about 0.01 to 100 mg, about 0.01 to 10 mg,about 0.1 to 1000 mg, about 0.1 to 100 mg, or about 0.1 to 10 mg,relative to the total amount of the preparation.

Sustained-Release Contact Lens Preparation

A sustained-release contact lens preparation in which the contact lensitself comprises GGA is another example of the ophthalmic agent. Such asustained-release preparation can be prepared by, for example, immersinga contact lens in a contact lens solution containing GGA, the contactlens solution being exemplified by a washing solution, a storagesolution, a sterilizing solution, a multipurpose solution, and a packagesolution, etc. Alternatively, GGA may be impregnated into a raw materialfor producing a contact lens, for example, a constituent monomer(hydroxyethyl methacrylate, methyl methacrylate, vinylpyrrolidone,divinylbenzene, methacrylic acid, ethylene glycol dimethacrylate,benzoin methyl ether, etc.) of a contact lens polymer, a colorant, or anultraviolet absorber, and with the use of these, the sustained-releasecontact lens can be prepared.

The GGA content of the sustained-release contact lens preparation ispreferably 0.001 mg or more, more preferably 0.01 mg or more, furthermore preferably 0.1 mg or more, relative to the total amount of thepreparation. The GGA content is preferably 1000 mg or less, morepreferably 100 mg or less, further more preferably 10 mg or less. GGA inthe above ranges is sufficient to exhibit the prophylactic, amelioratingor therapeutic effect for a retinal disease.

The GGA content of the sustained-release contact lens preparation is,for example, about 0.001 to 1000 mg, about 0.001 to 100 mg, about 0.001to 10 mg, about 0.01 to 1000 mg, about 0.01 to 100 mg, about 0.01 to 10mg, about 0.1 to 1000 mg, about 0.1 to 100 mg, or about 0.1 to 10 mg,relative to the total amount of the preparation.

Preferably the sustained-release contact lens preparation comprises GGAand another prophylactic, ameliorating or therapeutic component for aretinal disease. Such a combination is exemplified above. Thesustained-release contact lens preparation can further comprise apharmacologically or physiologically active component other than GGA.Such a component is exemplified above.

The dosage form of the ophthalmic agent is preferably an eye drop, anintraocular injection, an ophthalmic ointment, or an eye wash and ismore preferably an eye drop because of their good penetration into anaffected site.

(2) Oral Agent

GGA can be formulated into an oral agent or orally administered drug.Examples of the oral agent include, but are not limited to, solidpreparations such as tablets (including sublingual tablets and orallydisintegrating tablets), capsules (including soft capsules andmicrocapsules), granules, powders, tablet agents, chewable tablets, andtroches; liquid preparations such as syrups, emulsions, and suspensions;etc.

The solid preparation can be prepared by mixing GGA with apharmaceutically acceptable carrier, and as needed a pharmaceuticallyacceptable additive for an oral agent and a pharmacologically orphysiologically active component other than GGA in accordance with aknown method, for example, a method described in the JapanesePharmacopoeia.

Examples of the pharmaceutically acceptable carrier include, but are notlimited to, excipients such as lactose, saccharose, D-mannitol,D-sorbitol, starch, pregelatinized starch, dextrin, crystallinecellulose, low-substituted hydroxypropyl cellulose, carboxymethylcellulose sodium, gum arabic, pullulan, light anhydrous silicic acid,synthetic aluminum silicate, and magnesium aluminometasilicate; binderssuch as pregelatinized starch, sucrose, gelatin, gum arabic,methylcellulose, carboxymethyl cellulose, carboxymethylcellulose sodium,crystalline cellulose, saccharose, D-mannitol, trehalose, dextrin,pullulan, hydroxypropyl cellulose, hydroxypropyl methylcellulose, andpolyvinylpyrrolidone; disintegrants such as lactose, saccharose, starch,carboxymethyl cellulose, carboxymethyl cellulose calcium, croscarmellosesodium, carboxymethyl starch sodium, light anhydrous silicic acid, andlow-substituted hydroxypropyl cellulose; stabilizers such as anhydrouscitric acid, sodium laurate, and glycerol; etc.

The liquid preparation can also be prepared by a known method, forexample, a method described in the Japanese Pharmacopoeia. For example,the liquid preparation can be prepared by dissolving or dispersing GGAin water, ethanol, glycerin, simple syrup, or a mixture thereof.

To the oral agent may be added an additive for an oral agent, such as asweetener, an antiseptic, a lubricant, a diluent, a buffering agent, anaromatizing agent, a colorant, and an antioxidant.

Preferably the oral agent comprises GGA in combination with a componentthat prevents or treats a retinal disease with a different mechanism ofaction from that of the agent of the present invention. Examples of sucha combination include, but are not limited to, combinations of GGA and acarbonic anhydrase inhibitor, such as GGA and acetazolamide, GGA andmethazolamide, and GGA and diclofenamide; combinations of GGA and ahyperosmotic drug, such as GGA and concentrated glycerin, and GGA andisosorbide; etc.

Among these, preferred are combinations of GGA and a carbonic anhydraseinhibitor, more preferred are a combination of GGA and acetazolamide anda combination of GGA and methazolamide, and further more preferred is acombination of GGA and methazolamide.

Such components that prevent or treat a retinal disease with a differentmechanism of action from that of GGA can be used alone or in combinationof two or more thereof.

The oral agent can comprise a pharmacologically or physiologicallyactive component other than the prophylactic, ameliorating ortherapeutic component for a retinal disease.

Examples of such a known pharmacologically or physiologically activecomponent include nerve growth factors, decongestants, drugs forrestoring extraocular muscle function, anti-inflammatory drugs orastringent drugs, antihistaminics or antiallergics, vitamins, aminoacids, antibacterial drugs or bactericides, etc.

The GGA content of the oral agent in the form of a solid preparation ispreferably 0.001% by weight or more, more preferably 0.01% by weight ormore, further more preferably 0.1% by weight or more, relative to thetotal amount of the composition. The GGA content is preferably 80% byweight or less, more preferably 60% by weight or less, further morepreferably 50% by weight or less.

The GGA content of the oral agent in the form of a solid preparation is,for example, about 0.001 to 80% by weight, about 0.001 to 60% by weight,about 0.001 to 50% by weight, about 0.01 to 80% by weight, about 0.01 to60% by weight, about 0.01 to 50% by weight, about 0.1 to 80% by weight,about 0.1 to 60% by weight, or about 0.1 to 50% by weight, relative tothe total amount of the preparation.

The GGA content of the oral agent in the form of a liquid preparation ispreferably about 0.001% by weight or more, more preferably about 0.01%by weight or more, further more preferably about 0.1% by weight or more,relative to the total amount of the composition. The GGA content ispreferably about 80% by weight or less, more preferably about 60% byweight or less, further more preferably about 50% by weight or less.

The GGA content of the oral agent in the form of a liquid preparationis, for example, about 0.001 to 80% by weight, about 0.001 to 60% byweight, about 0.001 to 50% by weight, about 0.01 to 80% by weight, about0.01 to 60% by weight, about 0.01 to 50% by weight, about 0.1 to 80% byweight, about 0.1 to 60% by weight, or about 0.1 to 50% by weight,relative to the total amount of the preparation.

GGA in the above ranges is sufficient to exhibit the prophylactic,ameliorating or therapeutic effect for a retinal disease.

In the oral agent, the carriers, the additives, and thepharmacologically or physiologically active components other than GGAcan be used alone or in combination of two or more thereof.

(3) Injection

An injection can be prepared by dissolving or dispersing GGA in waterfor injection or physiological saline in accordance with a known method,for example, a method described in the Japanese Pharmacopoeia. Theinjection may comprise a pharmaceutically acceptable carrier such as asolubilizing agent, a suspending agent, a tonicity agent, a bufferingagent, a soothing agent, a stabilizer, an antiseptic, etc. and mayfurther comprise a pharmaceutically acceptable additive for aninjection.

Preferably the injection comprises, in addition to GGA, a component thatprevents or treats a retinal disease with a different mechanism ofaction from that of GGA. That is, the injection preferably comprises acombination of GGA and another component as active ingredients forpreventing, ameliorating or treating a retinal disease. Such componentsthat prevent or treat a retinal disease with a different mechanism ofaction from that of GGA can be used alone or in combination of two ormore thereof.

Examples of such a combination include, but are not limited to,combinations of GGA and a prostaglandin F2α derivative, such ascombinations of GGA and a prost drug (GGA and latanoprost, GGA andtravoprost, GGA and tafluprost, etc.), combinations of GGA and aprostamide drug (GGA and bimatoprost, etc.), and combinations of GGA anda prostone drug (GGA and isopropyl unoprostone); combinations of GGA anda sympatholytic agent such as, combinations of GGA and a β-blocker (GGAand timolol maleate, GGA and gel-forming timolol, GGA and carteololhydrochloride, GGA and gel-forming carteolol, etc.), combinations of GGAand a β1-blocker (GGA and betaxolol hydrochloride, etc.), combinationsof GGA and an αβ-blocker (GGA and levobunolol hydrochloride, GGA andnipradilol, GGA and bunazosin hydrochloride, etc.), and combinations ofGGA and an α2-blocker (GGA and brimonidine tartrate); combinations ofGGA and a parasympathomimetic drug, such as GGA and pilocarpinehydrochloride, and GGA and distigmine bromide; combinations of GGA and asympathomimetic drug, such as GGA and epinephrine, GGA and epinephrinebitartrate, and GGA and dipivefrin hydrochloride; combinations of GGAand a carbonic anhydrase inhibitor, such as GGA and dorzolamidehydrochloride, and GGA and brinzolamide; combinations of GGA and aspecific inhibitor to ROCK (Rho-associated coiled coil forming proteinkinase), such as GGA and SNJ-1656, and GGA and K-115; combinations ofGGA and a calcium antagonist, such as GGA and lomerizine hydrochloride;combinations of GGA and an EP2 agonist, such as GGA and DE-117;combinations of GGA and an adenosine A2a receptor agonist, such as GGAand OPA-6566; combinations of GGA and a therapeutic agent forage-related macular degeneration, such as combinations of GGA and a VEGFaptamer (GGA and pegaptanib sodium) and combinations of GGA and a VEGFinhibitor (GGA and ranibizumab, and GGA and bevacizumab).

Among these, preferred are combinations of GGA and a prostaglandin F2αderivative and combinations of GGA and a sympatholytic drug (especiallypreferred are combinations of GGA and a β-blocker) because thesecombinations exhibit a very high prophylactic, ameliorating ortherapeutic effect for a retinal disease.

The injection can comprise a pharmacologically or physiologically activecomponent other than the prophylactic, ameliorating or therapeuticcomponent for a retinal disease. Examples of the pharmacologically orphysiologically active component include nerve growth factors,decongestants, drugs for restoring extraocular muscle function,anti-inflammatory drugs or astringent drugs, antihistaminics orantiallergics, vitamins, amino acids, antibacterial drugs orbactericides, etc.

The GGA content of the injection is preferably 0.001% by weight or more,more preferably 0.01% by weight or more, further more preferably 0.1% byweight or more, relative to the total amount of the preparation. The GGAcontent is preferably 80% by weight or less, more preferably 60% byweight or less, further more preferably 50% by weight or less. GGA inthe above ranges is sufficient to exhibit the prophylactic, amelioratingor therapeutic effect for a retinal disease.

The GGA content of the injection is, for example, about 0.001 to 80% byweight, about 0.001 to 60% by weight, about 0.001 to is 50% by weight,about 0.01 to 80% by weight, about 0.01 to 60% by weight, about 0.01 to50% by weight, about 0.1 to 80% by weight, about 0.1 to 60% by weight,or about 0.1 to 50% by weight, relative to the total amount of thepreparation.

In the injection, the additives and the pharmacologically orphysiologically active components other than GGA can be used alone or incombination of two or more thereof.

(4) Percutaneous Absorption Agent

A percutaneous absorption agent is exemplified by a liniment prepared bymixing GGA with a (pharmaceutically acceptable) base usually used for apharmaceutical agent for external use and with a component other thanGGA.

Examples of the base include polymers such as sodium alginate, gelatin,corn starch, tragacanth gum, methylcellulose, hydroxyethyl cellulose,carboxymethyl cellulose, xanthan gum, carrageenan, mannan, agarose,dextrin, carboxymethyl starch, polyvinyl alcohol, sodium polyacrylate,methoxyethylene-maleic anhydride copolymers, polyvinyl ethers,polyvinylpyrrolidone, carboxy vinyl polymers, hydroxypropyl cellulose,hydroxypropyl methylcellulose, and pullulan; hydrocarbons such as whitepetrolatum, yellow petrolatum, paraffin, ceresin wax, andmicrocrystalline wax; hydrocarbon gels (e.g., Plastibase (trade name),Bristol-Myers Squibb Company); higher fatty acids such as stearic acid;higher alcohols such as cetanol, octyldodecanol, and stearyl alcohol;polyethylene glycols (e.g., macrogol 4000 etc.); polyalcohols such aspropylene glycol, glycerin, dipropylene glycol, 1,3-butylene glycol, andconcentrated glycerin; fatty acid esters such as monooleic acid estersand stearic acid glycerides; etc. To the percutaneous absorption agentmay also be added pharmaceutically acceptable additives for apercutaneous absorption agent, such as a solubilizing agent, aninorganic filler, a moisturizer, an antiseptic, a thickening agent, anantioxidant, and a cooling agent.

The percutaneous absorption agent may be a patch in which a linimentlayer comprising GGA is integrated with a support that supports thelayer. Methods for preparing such a patch are well known, and examplesthereof include a method described in the Japanese Pharmacopoeia.

The percutaneous absorption agent is also exemplified by a patchcomprising a liniment layer that is a multilayer laminate in whichconstituent layers have successively increased level of GGA for thepurpose of achieving sustained release of GGA.

The percutaneous absorption agent is also exemplified by a linimentcomprising an emulsified particle encapsulating GGA. This liniment canbe prepared by mixing GGA with a surfactant (a phospholipid, a nonionicsurfactant, etc.), water, and an oily base under agitation. Examples ofthe oily base include the above-described hydrocarbons, higher fattyacids, higher alcohols, polyalcohols, and fatty acid esters.

The percutaneous absorption agent is also exemplified by a dispersion inwhich a GGA suspension is dispersed in the form of microparticles in ahydrophobic polymer. Examples of the hydrophobic polymer include, butare not limited to, a polylactic acid.

Preferably the percutaneous absorption agent comprises, in addition toGGA, a component that prevents or treats a retinal disease with adifferent mechanism of action from that of GGA. That is, thepercutaneous absorption agent preferably comprises a combination of GGAand another component as active ingredients for preventing, amelioratingor treating a retinal disease. Such components that prevent or treat aretinal disease with a different mechanism of action from that of GGAcan be used alone or in combination of two or more thereof.

Examples of such a combination include, but are not limited to,combinations of GGA and a prostaglandin F2α derivative, such ascombinations of GGA and a prost drug (GGA and latanoprost, GGA andtravoprost, GGA and tafluprost, etc.), combinations of GGA and aprostamide drug (GGA and bimatoprost, etc.), and combinations of GGA anda prostone drug (GGA and isopropyl unoprostone); combinations of GGA anda sympatholytic agent such as, combinations of GGA and a β-blocker (GGAand timolol maleate, GGA and gel-forming timolol, GGA and carteololhydrochloride, GGA and gel-forming carteolol, etc.), combinations of GGAand a β-blocker (GGA and betaxolol hydrochloride, etc.), combinations ofGGA and an αβ-blocker (GGA and levobunolol hydrochloride, GGA andnipradilol, GGA and bunazosin hydrochloride, etc.), and combinations ofGGA and an α2-blocker (GGA and brimonidine tartrate); combinations ofGGA and a parasympathomimetic drug, such as GGA and pilocarpinehydrochloride, and GGA and distigmine bromide; combinations of GGA and asympathomimetic drug, such as GGA and epinephrine, GGA and epinephrinebitartrate, and GGA and dipivefrin hydrochloride; combinations of GGAand a carbonic anhydrase inhibitor, such as GGA and dorzolamidehydrochloride, and GGA and brinzolamide; combinations of GGA and aspecific inhibitor to ROCK (Rho-associated coiled coil forming proteinkinase), such as GGA and SNJ-1656, and GGA and K-115; combinations ofGGA and a calcium antagonist, such as GGA and lomerizine hydrochloride;combinations of GGA and an EP2 agonist, such as GGA and DE-117;combinations of GGA and an adenosine Ata receptor agonist, such as GGAand OPA-6566; combinations of GGA and a therapeutic agent forage-related macular degeneration, such as combinations of GGA and a VEGFaptamer (GGA and pegaptanib sodium) and combinations of GGA and a VEGFinhibitor (GGA and ranibizumab, and GGA and bevacizumab).

Among these, preferred are combinations of GGA and a prostaglandin F2αderivative and combinations of GGA and a sympatholytic drug (especiallypreferred are combinations of GGA and a β-blocker) because thesecombinations exhibit a very high prophylactic, ameliorating ortherapeutic effect for a retinal disease.

The percutaneous absorption agent can comprise a pharmacologically orphysiologically active component other than the prophylactic,ameliorating or therapeutic component for a retinal disease. Examples ofthe pharmacologically or physiologically active component includedecongestants, drugs for restoring extraocular muscle function,anti-inflammatory drugs or astringent drugs, antihistaminics orantiallergics, vitamins, amino acids, antibacterial drugs orbactericides, etc.

The GGA content of the percutaneous absorption agent is preferably0.001% by weight or more, more preferably 0.01% by weight or more,further more preferably 0.1% by weight or more, relative to the totalamount of the preparation. The GGA content is preferably 80% by weightor less, more preferably 60% by weight or less, further more preferably50% by weight or less. GGA in the above ranges is sufficient to exhibitthe prophylactic, ameliorating or therapeutic effect for a retinaldisease.

The GGA content of the percutaneous absorption agent is, for example,about 0.001 to 80% by weight, about 0.001 to 60% by weight, about 0.001to 50% by weight, about 0.01 to 80% by weight, about 0.01 to 60% byweight, about 0.01 to 50% by weight, about 0.1 to 80% by weight, about0.1 to 60% by weight, or about 0.1 to 50% by weight, relative to thetotal amount of the preparation.

In the percutaneous absorption, the additives and the pharmacologicallyor physiologically active components other than GGA can be used alone orin combination of two or more thereof.

(5) Suppository

A suppository can be prepared by mixing GGA with a pharmaceuticallyacceptable base, for example, an acrylic polymer such as Carbopol andpolycarbophil; a cellulose polymer such as hydroxypropyl cellulose andhydroxypropyl methylcellulose; a natural polymer such as sodium alginateand chitosan; a fatty acid wax; etc. in accordance with a known method,for example, a method described in the Japanese Pharmacopoeia.

To the suppository may be added a pharmaceutically acceptable additivefor a suppository, for example, an antiseptic such as sodium benzoate,potassium sorbate, and paraben; a pH adjusting agent such ashydrochloric acid, citric acid, and sodium hydroxide; a stabilizer suchas methionine; etc.

Preferably the suppository comprises, in addition to GGA, a componentthat prevents or treats a retinal disease with a different mechanism ofaction from that of GGA. That is, the suppository preferably comprises acombination of GGA and another component as active ingredients forpreventing, ameliorating or treating a retinal disease. Such componentsthat prevent or treat a retinal disease with a different mechanism ofaction from that of GGA can be used alone or in combination of two ormore thereof.

Examples of such a combination include, but are not limited to,combinations of GGA and a prostaglandin F2α derivative, such ascombinations of GGA and a prost drug (GGA and latanoprost, GGA andtravoprost, GGA and tafluprost, etc.), combinations of GGA and aprostamide drug (GGA and bimatoprost, etc.), and combinations of GGA anda prostone drug (GGA and isopropyl unoprostone); combinations of GGA anda sympatholytic agent such as, combinations of GGA and a β-blocker (GGAand timolol maleate, GGA and gel-forming timolol, GGA and carteololhydrochloride, GGA and gel-forming carteolol, etc.), combinations of GGAand a β1-blocker (GGA and betaxolol hydrochloride, etc.), combinationsof GGA and an αβ-blocker (GGA and levobunolol hydrochloride, GGA andnipradilol, GGA and bunazosin hydrochloride, etc.), and combinations ofGGA and an α2-blocker (GGA and brimonidine tartrate); combinations ofGGA and a parasympathomimetic drug, such as GGA and pilocarpinehydrochloride, and GGA and distigmine bromide; combinations of GGA and asympathomimetic drug, such as GGA and epinephrine, GGA and epinephrinebitartrate, and GGA and dipivefrin hydrochloride; combinations of GGAand a carbonic anhydrase inhibitor, such as GGA and dorzolamidehydrochloride, and GGA and brinzolamide; combinations of GGA and aspecific inhibitor to ROCK (Rho-associated coiled coil forming proteinkinase), such as GGA and SNJ-1656, and GGA and K-115; combinations ofGGA and a calcium antagonist, such as GGA and lomerizine hydrochloride;combinations of GGA and an EP2 agonist, such as GGA and DE-117;combinations of GGA and an adenosine Ata receptor agonist, such as GGAand OPA-6566; combinations of GGA and a therapeutic agent forage-related macular degeneration, such as combinations of GGA and a VEGFaptamer (GGA and pegaptanib sodium) and combinations of GGA and a VEGFinhibitor (GGA and ranibizumab, and GGA and bevacizumab).

Among these, preferred are combinations of GGA and a prostaglandin F2αderivative and combinations of GGA and a sympatholytic drug (especiallypreferred are combinations of GGA and a β-blocker) because thesecombinations exhibit a very high prophylactic, ameliorating ortherapeutic effect for a retinal disease.

The suppository can comprise a pharmacologically or physiologicallyactive component other than the prophylactic, ameliorating ortherapeutic component for a retinal disease. Examples of thepharmacologically or physiologically active component includedecongestants, drugs for restoring extraocular muscle function,anti-inflammatory drugs or astringent drugs, antihistaminics orantiallergics, vitamins, amino acids, antibacterial drugs orbactericides, etc.

The GGA content of the suppository is preferably 0.001% by weight ormore, more preferably 0.01% by weight or more, further more preferably0.1% by weight or more, relative to the total amount of the preparation.The GGA content is preferably 80% by weight or less, more preferably 60%by weight or less, further more preferably 50% by weight or less. GGA inthe above ranges is sufficient to exhibit the prophylactic, amelioratingor therapeutic effect for a retinal disease.

The GGA content of the suppository is, for example, about 0.001 to 80%by weight, about 0.001 to 60% by weight, about 0.001 to 50% by weight,about 0.01 to 80% by weight, about 0.01 to 60% by weight, about 0.01 to50% by weight, about 0.1 to 80% by weight, about 0.1 to 60% by weight,or about 0.1 to 50% by weight, relative to the total amount of thepreparation.

In the suppository, the additives and the pharmacologically orphysiologically active components other than GGA can be used alone or incombination of two or more thereof.

(6) Inhalant

An inhalant is exemplified by a powder inhalant, a liquid inhalant, anaerosol, etc. Preparation methods therefor are well known.

A powder inhalant can be prepared by, for example, pulverizing GGA by aconventional method, and as needed mixing with an excipient such aslactose. The powder inhalant can be administered with an inhalator suchas Spinhaler (registered trade name).

A liquid inhalant can be prepared by, for example, adding GGA and asneeded a pharmaceutically acceptable additive for a liquid inhalant to apharmaceutically acceptable base such as purified water and water forinjection, and dissolving them under stirring. Examples of thepharmaceutically acceptable additive for a liquid inhalant include atonicity agent such as sodium chloride, a buffering agent such as aborate buffering agent and a phosphate buffering agent, a preservativesuch as benzalkonium chloride, a thickening agent such as a carboxyvinyl polymer, etc. The liquid inhalant is administered with aninhalator such as nebulizer (registered trade name).

An aerosol can be prepared by, for example, pulverizing GGA by aconventional method, adding a dispersant as needed, and filling theminto a spray container with a propellant under cooling. Examples of thepropellant include a liquefied hydrofluoroalkane (HFA 134a(1,1,1,2-tetrafluoroethane: CH₂FCF₃), HFA 227(1,1,1,2,3,3,3-heptafluoropropane:

CF₃—CHF—CF₃), etc.) etc. Examples of the dispersant include a mediumchain fatty acid triglyceride such as miglyol 812 (trademark) (DynamitNobel AG); soybean lecithin; etc.

Preferably the inhalant comprises, in addition to GGA, a component thatprevents or treats a retinal disease with a different mechanism ofaction from that of GGA. That is, the inhalant preferably comprises acombination of GGA and another component as active ingredients forpreventing, ameliorating or treating a retinal disease. Such componentsthat prevent or treat a retinal disease with a different mechanism ofaction from that of GGA can be used alone or in combination of two ormore thereof.

Examples of such a combination include, but are not limited to,combinations of GGA and a prostaglandin F2α derivative, such ascombinations of GGA and a prost drug (GGA and latanoprost, GGA andtravoprost, GGA and tafluprost, etc.), combinations of GGA and aprostamide drug (GGA and bimatoprost, etc.), and combinations of GGA anda prostone drug (GGA and isopropyl unoprostone); combinations of GGA anda sympatholytic agent such as, combinations of GGA and a β-blocker (GGAand timolol maleate, GGA and gel-forming timolol, GGA and carteololhydrochloride, GGA and gel-forming carteolol, etc.), combinations of GGAand a β1-blocker (GGA and betaxolol hydrochloride, etc.), combinationsof GGA and an αβ-blocker (GGA and levobunolol hydrochloride, GGA andnipradilol, GGA and bunazosin hydrochloride, etc.), and combinations ofGGA and an α2-blocker (GGA and brimonidine tartrate); combinations ofGGA and a parasympathomimetic drug, such as GGA and pilocarpinehydrochloride, and GGA and distigmine bromide; combinations of GGA and asympathomimetic drug, such as GGA and epinephrine, GGA and epinephrinebitartrate, and GGA and dipivefrin hydrochloride; combinations of GGAand a carbonic anhydrase inhibitor, such as GGA and dorzolamidehydrochloride, and GGA and brinzolamide; combinations of GGA and aspecific inhibitor to ROCK (Rho-associated coiled coil forming proteinkinase), such as GGA and SNJ-1656, and GGA and K-115; combinations ofGGA and a calcium antagonist, such as GGA and lomerizine hydrochloride;combinations of GGA and an EP2 agonist, such as GGA and DE-117;combinations of GGA and an adenosine A2a receptor agonist, such as GGAand OPA-6566; combinations of GGA and a therapeutic agent forage-related macular degeneration, such as combinations of GGA and a VEGFaptamer (GGA and pegaptanib sodium) and combinations of GGA and a VEGFinhibitor (GGA and ranibizumab, and GGA and bevacizumab).

Among these, preferred are combinations of GGA and a prostaglandin F2αderivative and combinations of GGA and a sympatholytic drug (especiallypreferred are combinations of GGA and a β-blocker) because thesecombinations exhibit a very high prophylactic, ameliorating ortherapeutic effect for a retinal disease.

The inhalant can comprise a pharmacologically or physiologically activecomponent other than the prophylactic, ameliorating or therapeuticcomponent for a retinal disease. Examples of the pharmacologically orphysiologically active component include decongestants, drugs forrestoring extraocular muscle function, anti-inflammatory drugs orastringent drugs, antihistaminics or antiallergics, vitamins, aminoacids, antibacterial drugs or bactericides, etc.

The GGA content of the inhalant is preferably 0.001% by weight or more,more preferably 0.01% by weight or more, further more preferably 0.1% byweight or more, relative to the total amount of the preparation. The GGAcontent is preferably 80% by weight or less, more preferably 60% byweight or less, further more preferably 50% by weight or less. GGA inthe above ranges is sufficient to exhibit the prophylactic, amelioratingor therapeutic effect for a retinal disease.

The GGA content of the inhalant is, for example, about 0.001 to 80% byweight, about 0.001 to 60% by weight, about 0.001 to 50% by weight,about 0.01 to 80% by weight, about 0.01 to 60% by weight, about 0.01 to50% by weight, about 0.1 to 80% by weight, about 0.1 to 60% by weight,or about 0.1 to 50% by weight, relative to the total amount of thepreparation.

In the inhalant, the additives and the pharmacologically orphysiologically active components other than GGA can be used alone or incombination of two or more thereof.

Kit

The agent of the present invention may be a kit comprising separatecompositions: a composition comprising GGA and a composition comprisinga pharmacologically or physiologically active component other than GGA;or may be a composition comprising all the components in a single dosageform. The agent of the present invention may also be a kit comprisingseparate compositions: a composition comprising GGA and a compositioncomprising a particular additive. In a kit, compositions may beseparately packed into different containers, or may be packed into acontainer that allows mixing at the time of use (compositions to beprepared at the time of use). In a kit, any number (e.g., two, three,etc.) of dosage forms may be contained.

When the agent of the present invention is a kit comprising separatecompositions: a composition comprising GGA and a composition comprisinganother component (including the above cases of a kit comprisingcompositions separately packed into different containers and a kitcomprising compositions to be prepared at the time of use), the GGAcontent described above for each type of preparation is the percentagerelative to the total amount of the mixed compositions.

Target Diseases

A target retinal disease of the present invention may be any retinaldisease as long as it is a disease involving the degeneration,impairment or destruction of a constituent cell of the retina, or adisease resulting from the degeneration, impairment or destruction of aconstituent cell of the retina. Examples of these diseases includeglaucoma, retinitis pigmentosa, age-related macular degeneration,diabetic retinopathy, retinal detachment, diabetic maculopathy,hypertensive retinopathy, retinal vascular occlusion (retinal arteryocclusion; retinal vein occlusion such as central retinal vein occlusionand branch retinal vein occlusion; etc.), retinal arteriosclerosis,retinal tear, retinal hole, macular hole, ophthalmorrhagia, posteriorvitreous detachment, pigmented paravenous retinochoroidal atrophy,gyrate atrophy of the retina and choroid, choroideremia, crystallineretinopathy, retinitis punctata albescens, corneal dystrophy, conedystrophy, central areolar choroidal dystrophy, Doyne's honeycombretinal dystrophy, vitelliform macular dystrophy, cystoid macular edema,occult macular dystrophy, Stargardt disease, retinoschisis, centralserous chorioretinopathy (central retinopathy), spinocerebellar ataxiatype 7, familial exudative vitreoretinopathy, enhanced S-cone syndrome,angioid streaks, autosomal dominant optic atrophy, autosomal dominantdrusen, familial drusen, acute zonal occult outer retinopathy,cancer-associated retinopathy, light damage, ischemic retinopathy,inflammation-induced retinal degenerative disease, etc.

Among these, more suitable target diseases are glaucoma, retinitispigmentosa, age-related macular degeneration, and diabetic retinopathy,and furthermore suitable target disease is glaucoma.

The target disease of the present invention also includes a diseaseinvolving the impairment of any constituent cell of the retina, and adisease resulting from the impairment of any constituent cell of theretina. Examples of the constituent cells of the retina include retinalganglion cells, amacrine cells, horizontal cells, Muller glial cells,bipolar cells, retinal visual cells (cones and rods), retinal pigmentepithelial cells, etc. Especially suitable target is a disease involvingor resulting from the impairment of retinal ganglion cells or retinalpigment epithelial cells.

The target disease of the present invention also includes a diseaseinvolving or resulting from the impairment of any of the constituentlayers of the retina, i.e., the inner limiting membrane, the nerve fiberlayer, the ganglion cell layer, the inner plexiform membrane, the innernuclear layer, the outer plexiform layer, the outer nuclear layer, theexternal limiting membrane, the visual cell layer, and the retinalpigment epithelium layer. Particularly suitable target is a diseaseinvolving or resulting from the impairment of the ganglion cell layer,the inner nuclear layer, or the outer nuclear layer.

The target patient to whom the present invention is suitably applied isa patient with the above retinal disease.

As described above, GGA contained in the agent of the present inventionprotects a retinal cell, i.e., promotes the survival of a retinal cellor inhibiting the degeneration, impairment or destruction of a retinalcell, thereby preventing, ameliorating or treating a retinal disease.

Therefore, the present invention encompasses a protective agent for aretinal cell, a promoting agent for the survival of a retinal cell, or asuppressing agent for the degeneration, impairment or destruction of aretinal cell, these agent comprising, as an active ingredient, GGA which

(a) is a mixture of the all-trans form and the mono-cis form (inparticular the 5Z-mono-cis form), the all-trans form content of themixture being 80% by weight or more,(b) consists of the all-trans form,(c) consists of the 5Z-mono-cis form, or(d) is a mixture of the all-trans form and the mono-cis form (inparticular the 5Z-mono-cis form), the mono-cis form content of themixture being very high.

Particularly suitable target retinal cells of these agents are asdescribed above. The components, dose, properties, dosage form, etc. ofthe preparations are as described for the prophylactic, ameliorating ortherapeutic agent for a retinal disease of the present invention.

In the present invention, the term “prophylactic” is understood toinclude preventing or delaying the onset of a disease and reducing theincidence, and the term “ameliorating” and “therapeutic” are understoodto include reducing the symptoms, suppressing the progress of thesymptoms, and leading to remission or cure.

Usage <Ophthalmic Preparation>

When the agent of the present invention is an eye drop, the eye dropcomprising GGA in the above concentration ranges is instilled, forexample, about 1 to 5 times a day, preferably about 1 to 3 times a day,in an amount of about 1 to 2 drops each time.

When the agent of the present invention is an eye wash, eye washing isperformed, for example, about 1 to 10 times a day, preferably about 1 to5 times a day, each time using about 1 to 20 mL of the eye washcomprising GGA in the above concentration ranges.

When the agent of the present invention is an ophthalmic ointment, theophthalmic ointment comprising GGA in the above concentration ranges isapplied to the eye, for example, about 1 to 5 times a day, preferablyabout 1 to 3 times a day, in an amount of about 0.001 to 5 g each time.

When the agent of the present invention is an intraocular injection, theintraocular injection comprising GGA in the above concentration rangesis injected, for example, about 1 to 3 times per day to 14 days,preferably once per day to 14 days, in an amount of about 0.005 to 1 mLeach time.

When the agent of the present invention is a contact lens solution (awashing solution, a storage solution, a sterilizing solution, amultipurpose solution, package solution, etc.), a preservative for aharvested ocular tissue (a cornea etc.) for transplantation, or anirrigating solution for surgery, such a composition comprising GGA inthe above concentration ranges is used in a usual dosage and regimen ofsuch a type of preparation.

When the agent of the present invention is a sustained-release contactlens preparation, the contact lens comprising GGA in the above amount isreplaced with a fresh one, for example, about 1 to 3 times per day to 14days, preferably once per day to 14 days.

When the agent of the present invention is a sustained-releaseintraocular implant, about 1 to 14 days after the implantation of theimplant comprising GGA in the above amount, a fresh one is implanted asneeded.

When the agent of the present invention is an ophthalmic composition,the daily dosage of GGA is preferably 50 ng or more, more preferably 500ng or more, further more preferably 5 μg or more. The daily dosage ofGGA is preferably 50 mg or less, more preferably 20 mg or less, furthermore preferably 10 mg or less.

When the agent of the present invention is an ophthalmic composition,the daily dosage of GGA is, for example, about 50 ng to 50 mg, about 50ng to 20 mg, about 50 ng to 10 mg, about 500 ng to 50 mg, about 500 ngto 20 mg, about 500 ng to 10 mg, about 5 μg to 50 mg, about 5 μg to 20mg, or about 5 μg to 10 mg.

<Other Preparations>

When the agent of the present invention is in a dosage form other thanan ophthalmic preparation, the daily dosage of GGA is preferably about0.1 mg or more, more preferably about 1 mg or more, further morepreferably about 5 mg or more. The daily dosage of GGA is preferablyabout 5000 mg or less, more preferably about 1000 mg or less, furthermore preferably about 500 mg or less.

When the agent of the present invention is in a dosage form other thanan ophthalmic preparation, the daily dosage of GGA is, for example,preferably about 0.1 to 5000 mg, more preferably about 1 to 1000 mg,further more preferably about 5 to 500 mg. The daily dosage is dividedinto, for example, about 1 to 5 administrations, preferably about 1 to 3administrations.

The administration period varies depending on the type and stage of thedisease, the age, weight, and sex of the patient, the route ofadministration, etc., and can be selected as appropriate, for example,from the range from about one day to 30 years. For example, when thepatient has a retinal disease such as glaucoma, retinitis pigmentosa,age-related macular degeneration and diabetic retinopathy, the retinaldisease may be prevented for, ameliorated in or cured in anadministration period of about 1 to 20 years, especially as short as 1to 10 years. When the retinal protective action exhibited by theophthalmic composition of the present invention suppresses the progressof a retinal disease, the administration can be further continued.

The present invention includes

(i) a method for preventing, ameliorating or treating a retinal disease,the method comprising the step of administering to a patient with aretinal disease an effective amount of the GGA described in thefollowing (a), (b), (c) or (d), thereby preventing, ameliorating ortreating the retinal disease,(ii) a method for suppressing the degeneration, impairment ordestruction of a retinal cell, the method comprising the step ofadministering to a patient with a retinal disease an effective amount ofthe GGA described in the following (a), (b), (c) or (d), therebysuppressing the degeneration, impairment or destruction of a retinalcell, and(iii) a method for protecting a retinal cell, the method comprising thestep of administering to a patient with a retinal disease an effectiveamount of the GGA described in the following (a), (b), (c) or (d),thereby protecting a retinal cell:(a) a mixture of the all-trans form and the mono-cis form (in particularthe 5Z-mono-cis form), the all-trans form content of the mixture being80% by weight or more,(b) GGA consisting of the all-trans form,(c) GGA consisting of the 5Z-mono-cis form, or(d) a mixture of the all-trans form and the mono-cis form (in particularthe 5Z-mono-cis form), the mono-cis form content of the mixture beingvery high.

GGA is administered in any of the preparation forms of the presentinvention described above. The administration method varies depending onthe dosage forms and examples of the administration method includeocular instillation, eye washing, application to the eye, spray to theeye, implantation to the eye, wearing a contact lens, injection(injection into the eye, for example, injection into the vitreous bodyetc., intravenous injection, hypodermic injection, intramuscularinjection), oral administration, transdermal administration, insertioninto the rectum, inhalation, etc. In the case of the ophthalmic agent,the agent is administered to the eye.

The target disease, the target patient and the type of retinal cells tobe targeted are as described for the agent of the present invention.

EXAMPLES

The present invention will be described in more detail below withreference to Examples, but the present invention is not limited thereto.

(1) Preparation of Geranylgeranylacetone

Marketed teprenone (all-trans form: 5Z-mono-cis form=3:2 (weight ratio))(Wako Pure Chemical Industries, Ltd.) was purchased and the all-transform was separated and purified by silica gel chromatography.

The above preparative purification was carried out using silica gel(PSQ60B, Fuji Silysia Chemical Ltd.) filled in a glass tube and a mobilephase of n-hexane/ethyl acetate (9:1). After the separation, eachfraction was concentrated and dried under reduced pressure and thedegree of purification and structure of the all-trans form weredetermined by GC and ¹H-NMR (solvent:deuterated chloroform; internalstandard: tetramethylsilane) (about 20% yield).

<GC Measurement Conditions>

Column: DB-1 (J&W Scientific, 0.53 mm×30 m, film thickness of 1.5 μm)Column temperature: elevated at a rate of 5° C./minute from 200° C. to300° C. (10 minutes)Vaporizing chamber temperature: 280° C.Detector temperature: 280° C.Carrier gas: heliumHydrogen pressure: 60 kPaAir pressure: 50 kPaMakeup gas pressure: 75 kPa (nitrogen gas)Total flow: 41 mL/minColumn flow: 6.52 mL/minLinear velocity: 58.3 cm/secSplit ratio: 5:1Injection volume: 1 μL of 0.1 g/100 mL sample (in ethanol)

The marketed teprenone and the all-trans form purified as describedabove were mixed at various ratios to give GGAs at desired weight ratios(all-trans form: 5Z-mono-cis form=7:3, 8:2, 9:1, etc. (weight ratio)).Since the stability of the mixtures was unknown, the mixtures wereprepared at the time of use.

(2) Evaluation of Protective Effect for Retinal Neuronal Cells AgainstIschemic Cell Death Induced by Hypoxia and Low Glucose

The progress of visual impairment in glaucoma is associated with retinalganglion cell (RGC) death due to blood flow failure occurring near theoptic nerve (Folia Pharmacol. Jpn. 128, 255-258 (2006)). With the use ofPC12, which is a typical neural cell line established from rat adrenalcortex pheochromocytoma and used also as a model cell for the functionalevaluation of RGC (J Neurosci Res. 2000 May 15; 60 (4): 495-503.), thecytoprotective effect of GGA against ischemic cell death induced byhypoxia and low glucose was evaluated.

<Evaluation Method>

Test samples were prepared as follows. The test substances were fourtypes of GGAs that contain the all-trans form and the 5Z-mono-cis format a weight ratio of 10:0, 8:2, 6:4, and 0:10, respectively. An amountof 100 mg of each GGA and 0.25 mg of DL-α-tocopherol acetate (Wako PureChemical Industries) as an antioxidant were weighed out and dissolved in789 mg of 100% ethanol. A base was prepared in the same manner asdescribed above except that GGA was not used. Each of the GGAs having aweight ratio of 10:0, 8:2, and 6:4 dissolved in 789 mg of 100% ethanolwas diluted with a high-glucose (4.5 g/L) Dulbecco's modified Eagle'sbasal medium (DMEM) supplemented with 10% (v/v) horse serum (DS PharmaBiomedical) and 5% (v/v) fetal calf serum (Daiichi Pure Chemicals) to aconcentration adjusted so that the all-trans form content wassubstantially 30 μM. The GGA having a weight ratio of 0:10 containingonly the 5Z-mono-cis form was also diluted so that the concentration was30 μM. The base was diluted by the same dilution factor as that for theGGA having a weight ratio of the all-trans form: the 5Z-mono-cis form of6:4.

PC12 (purchased from DS Pharma Biomedical) was seeded onto a collagen IVcoated 96-well microplate (IWAKI) at 2.0×10⁴ cells/100 mL per well andincubated in the DMEM described above under 5% CO₂ at 37° C. for 48hours.

After 48 hours of incubation, the supernatant of the cell culture wasremoved and replaced with the previously prepared DMEMs containing theGGAs and incubation was performed under 5% CO₂ at 37° C. for 2 hours.After 2 hours of incubation, the medium was replaced with a low-glucose(1.0 g/L) DMEM supplemented with 2% horse serum and 1% fetal calf serum,the oxygen condition was changed to zero percent O₂ using Anaeropack 5%(Mitsubishi Gas Chemical), and incubation was performed under 5% CO₂ andthe low oxygen condition at 37° C. for 8 hours. For a non-treated group,incubation was performed in a high-glucose (4.5 g/L) DMEM supplementedwith 2% (v/v) horse serum and 1% (v/v) fetal calf serum under 5% CO₂ andnormal oxygen concentration at 37° C. for 8 hours.

<Test Results>

After 8 hours of incubation, 100 μL of an equivalent mixture of a cellviability detection reagent Cell Titer-Glo (Promega) and PBS was addedto each well and the luminescence produced by the reaction with ATP inliving cells was measured with a luminometer (GloMax; Promega). The cellviability was calculated from the measured luminescence by the followingformula and the cytoprotective effect of GGA against oxidative stress byhydrogen peroxide was examined.

Cell viability (%)=100×[(luminescence of base- or GGA-treatedgroup)/(luminescence of non-treated group)]

The results are shown in FIG. 1. As is apparent from FIG. 1, theGGA-treated groups showed significantly higher cell viabilities at allweight ratios than that of the base-treated group. The GGAs having aweight ratio of the all-trans form: the 5Z-mono-cis form of 10:0, 8:2,and 0:10 showed significantly higher cytoprotective effects than that ofthe GGA having a weight ratio of 6:4. (n=10, *: P<0.05, **: P<0.01, byTukey-Kramer test. No significant difference was observed among 8:2,10:0, and 0:10.)

(3) Evaluation of Neurite Outgrowth Inducing Effect Using Culture Systemof Rat-Derived Retinal Ganglion Cells (RGC)

The progress of visual impairment in glaucoma is associated with retinalganglion cell (RGC) death due to blood flow failure occurring near theoptic nerve (Folia Pharmacol. Jpn. 128, 255-258 (2006)). Accordingly, aculture system of rat-derived retinal neurons (Current protocols inNeuroscience 3.22.1-3.22.10, October 2010), which is widely used as oneof study tools for optic nerve diseases such as a glaucoma, was used toexamine the neurite outgrowth inducing effect of GGA.

<Evaluation Method>

Four-day-old Wistar rats (Japan SLC, Inc.) were euthanized by cervicaldislocation and the eyeballs were harvested. The harvested eyeballs wereimmersed in 70% ethanol for 10 seconds and transferred to a Hanks'balanced salt solution containing 100 U/mL penicillin and 100 μg/mLstreptomycin. Under a stereoscopic microscope, the corneas, irises,crystalline lenses, and vitreous bodies were removed using scissors forsurgery and forceps, and the retinal tissue was harvested. The harvestedretinal tissue was transferred to a centrifugation tube containing 5 mLof a basal medium for neuronal cells (Neurobasal, Invitrogen) containing100 U/mL penicillin, 100 μg/mL streptomycin, a neural cell culturesupplement (B27™-Supplement, Invitrogen), 1 μL-cysteine (Kyowa HakkoBio) and 15 U/mL papain (Sigma Aldrich) and incubated at 37° C. for 30minutes. Thirty minutes later, the supernatant was removed and thetissue was washed twice with Neurobasal containing 100 U/mL penicillin,100 μg/mL streptomycin, and B27™-Supplement. After washing, 2 mL ofNeurobasal was added, the tissue was divided into small cell masses bypipetting with a dry-heat sterilized Pasteur pipette (Hilgenberg), andtransferred to 50 mL of Neurobasal that was prepared in advance.

After centrifugation at 900×g for 5 minutes, the supernatant wasremoved, and the residue was suspended again in 6 mL of Neurobasal togive a cell suspension. The cell suspension was filtered through a 40 μmnylon mesh cell strainer (Japan BD) for removal of aggregated cellmasses. The obtained cells were seeded onto a poly-D-lysine/laminincoated 6-well plate (Japan BD) and incubated under 5% CO₂ at 37° C.

The test substances were two types of GGAs: GGA consists of theall-trans form, and GGA contains the all-trans form and the 5Z-mono-cisform at a weight ratio of 6:4. An amount of 100 mg of each GGA and 0.25mg of DL-α-tocopherol acetate (Wako Pure Chemical Industries) as anantioxidant were weighed out and dissolved in 789 mg of 100% ethanol. Abase was prepared in the same manner as described above except that GGAwas not used. The concentration of each of the GGAs having a weightratio of 10:0 and 6:4 dissolved in 789 mg of 100% ethanol was adjustedso that the all-trans form content was substantially 3 μM. The base wasdiluted by the same dilution factor as that for the GGA of 6:4. Each ofthe GGAs and the base were then added to the cell culture supernatant 2hours after cell seeding and incubation was performed under 5% CO₂ at37° C. for 48 hours.

<Results>

After 48 hours of incubation, the cell culture supernatant was removedand the cells were fixed with a 4% paraformaldehyde phosphate buffersolution (Wako Pure Chemical Industries) and 100% methanol (Wako PureChemical Industries) at room temperature for 30 minutes. The cells werewashed with phosphate buffer (PBS) (Kohj in Bio) and blocking wasperformed with PBS containing 2% (w/v) bovine serum albumin (SigmaAldrich) and 0.05% (v/v) Tween 20 (Sigma Aldrich) at room temperaturefor 30 minutes. Thirty minutes later, 1 mL of βIII tubulin antibody(Promega) diluted to 1000-fold in PBS was added to each well andincubation was performed at room temperature for 2 hours. Two hourslater, the diluted antibody solution was removed and washing with PBSwas performed 3 times. Then, 1 mL of Alexa Fluor 488 goat anti-mouseantibody (Invitrogen) diluted to 1000-fold in PBS was added to each welland incubation was performed at room temperature for 1 hour. One hourlater, the diluted antibody solution was removed, washing with PBS wasperformed 3 times, and 3 mL of PBS was added to each well. With the useof an imaging cytometer (In Cell Analyzer 1000, GE HealthcareBioscience), examination was performed at arbitrarily selected 4locations in each well (excitation wavelength: 475 nm; fluorescencewavelength: 535 nm), and the mean of the length (μm) of the fluorescencestained neurites of RGC was calculated.

The results are shown in FIG. 2. As is apparent from FIG. 2, the grouptreated with GGA having a weight ratio of the all-trans form: the5Z-mono-cis form of 10:0 showed a significant neurite inducing effect ascompared with the group treated with GGA having a weight ratio of theall-trans form: the 5Z-mono-cis form of 6:4 and the base-treated group(n=4, *: P<0.05, **: P<0.01, by Tukey-Kramer test).

Typical observation images of the fluorescence stained rat RGC are shownin FIG. 3. As is apparent form the images, the group treated with GGA of10:0 showed a significant neurite inducing effect as compared with thegroup treated with GGA of 6:4.

(4) Evaluation of Protective Effect for Retinal Pigment Epithelial CellsAgainst Oxidative Stress by Hydrogen Peroxide

The involvement of oxidative stress in ophthalmologic diseases has beenwidely reported. Such involvement has been observed in, in addition toglaucoma and cataract, retinal diseases such as retinal diseases due todiabetes, hypertension, hyperlipemia, etc., age-related maculardegeneration, retinopathy of prematurity, retinal vascular occlusion,retinal light damage, etc. (Nippon Ganka Gakkai Zasshi. 112, 22-29(2008)). In the retina, the retinal pigment epithelium exists in anenvironment in which reactive oxygen easily generates (Invest OpthalmolV is Sci. 2006 July 47(7): 3164-3177.). The cytoprotective effect of GGAagainst oxidative stress by hydrogen peroxide was examined using ahuman-derived retinal pigment epithelial cell line, ARPE-19.

<Evaluation Method>

The test substances were three types of GGAs that contain the all-transform and the 5Z-mono-cis form at a weight ratio of 10:0, 8:2, and 6:4,respectively, and with the use of these test substances, test solutionswere prepared as follows. An amount of 100 mg of each GGA and 0.25 mg ofDL-α-tocopherol acetate (Wako Pure Chemical Industries) as anantioxidant were weighed out and dissolved in 789 mg of 100% ethanol. Abase was prepared in the same manner as described above except that GGAwas not used. Each of the GGAs having a weight ratio of 10:0, 8:2, and6:4 dissolved in 100% ethanol was diluted with a Dulbecco's modifiedEagle's basal medium/Ham's-F12 mixed liquid medium (1:1) (DMEM/F-12,Invitrogen) supplemented with 10% (v/v) fetal calf serum (Daiichi PureChemicals) to a concentration adjusted so that the all-trans formcontent was substantially 280 μM. The base was diluted by the samedilution factor as that for the GGA of 6:4. The above diluted solutionswere used as test solutions.

ARPE-19 (purchased from ATCC) was seeded onto a 96-well microplate(CORNING) at 1.5×10⁴ cells/100 μL per well and incubated in theDMEM/F-12 described above under 5% CO₂ at 37° C. for 48 hours.

After 48 hours of incubation, the supernatant of the cell culture wasremoved and replaced with the previously prepared test solutions andincubation was performed under 5% CO₂ at 37° C. for 14 hours.Immediately before the end of the incubation, a DMEM/F-12 supplementedwith 750 μM hydrogen peroxide was prepared by adding hydrogen peroxidefor precision analysis (Wako Pure Chemical Industries) to a DMEM/F-12.After 14 hours of incubation, the cell culture supernatant was removedand 200 μL of phosphate buffer (PBS, Kohj in Bio) was added to eachwell. PBS was promptly removed and replaced with the previously preparedDMEM/F-12 supplemented with hydrogen peroxide, and incubation wasperformed under 5% CO₂ at 37° C. for 2 hours. For a non-treated group,PBS was replaced with a DMEM/F-12 not containing hydrogen peroxide.

<Results>

After 2 hours of incubation, the cell culture supernatant was removed,and 200 μL of PBS was added to each well and promptly removed. Then, 100μL of an equivalent mixture of a cell viability detection reagent CellTiter-Glo (Promega) and PBS was added to each well and the luminescenceproduced by the reaction with ATP in living cells was measured with aluminometer (GloMax; Promega). The cell viability was calculated fromthe measured luminescence by the following formula and thecytoprotective effect of GGA against oxidative stress by hydrogenperoxide was examined.

Cell viability (%)=100×[(luminescence of base- or GGA-treatedgroup)/(luminescence of non-treated group)]

The results are shown in FIG. 4. As is apparent from FIG. 4, theGGA-treated groups showed higher cell viabilities at all weight ratiosthan that of the base-treated group. The GGAs of 10:0 and 8:2 showedsignificantly higher cell viabilities than that of the base-treatedgroup (n=3, *: P<0.05, ***: P<0.001, by Tukey-Kramer test).

(5) Evaluation of Inhibitory Effect on IL-8 Production from RetinalPigment Epithelial Cells

Age-related macular degeneration is known to involve the accumulation ofdrusen under the retinal pigment epithelium. Drusen attract macrophagesand macrophages secrete TNF-α. TNF-α acts on the retinal pigmentepithelium and its peripheral tissue, and the cells subsequently producea variety of cytokines and cause inflammation (Mol. Vis. 2008 14:2292-303). Atypical cytokine that is involved in neutrophil migrationand spreads inflammation is interleukin-8 (IL-8). In this experiment,the inhibitory effect of GGA on IL-8 production by TNF-α was examinedusing a human-derived retinal pigment epithelial cell line, ARPE-19.

<Evaluation Method>

The test substances were two types of GGAs: GGA consists of theall-trans form, and GGA contains the all-trans form and the 5Z-mono-cisform at a weight ratio of 6:4. With the use of these test substances,test solutions were prepared as follows. An amount of 100 mg of each GGAand 0.25 mg of DL-α-tocopherol acetate as an antioxidant were weighedout and dissolved in 789 mg of 100% ethanol. A base was prepared in thesame manner as described above except that GGA was not used. Each of theGGAs, which were the GGA consisting of the all-trans form and the GGAcontaining the all-trans form and the 5Z-mono-cis form at a weight ratioof 6:4, dissolved in 789 mg of 100% ethanol was diluted with a DMEM/F-12to a concentration adjusted so that the all-trans form content wassubstantially 50 μM. The base was diluted by the same dilution factor asthat for the GGA having a weight ratio of the all-trans form: the5Z-mono-cis form of 6:4. The above diluted solutions were used as testsolutions.

ARPE-19 was seeded onto a 96-well microplate (CORNING) at 2.5×10⁴cells/100 μL per well and incubated in a DMEM/F-12 supplemented with 10%(v/v) fetal calf serum under 5% CO₂ at 37° C. for 24 hours.

After 24 hours of incubation, the supernatant of the cell culture wasremoved, 200 μL of each of the previously prepared test solutions wasadded to each well, and incubation was performed under 5% CO₂ at 37° C.for 16 hours. For a non-treated group, a DMEM/F-12 was added in the samemanner as described above and incubation was performed. Immediatelybefore the end of the incubation, recombinant human TNF-α (R&D Systems)was prepared in a DMEM/F-12 to a concentration of 10 ng/mL. After hoursof incubation, 2 μL of the previously prepared DMEM/F-12 supplementedwith TNF-α was added to the test solution in each well, and incubationwas performed under 5% CO₂ at 37° C. for 4 hours. The non-treated groupwas incubated in the same manner except that TNF-α was not addedthereto.

<Results>

After 4 hours of incubation, 150 μL of the cell culture supernatant wascollected and stored at −80° C. The rest of the cell culture supernatantwas removed, and 200 μL of PBS was added to each well and promptlyremoved. Then, 100 μL of an equivalent mixture of a cell viabilitydetection reagent Cell Titer-Glo and PBS was added to each well and theluminescence produced by the reaction with ATP in living cells wasmeasured with a luminometer. From the measured luminescence, the cellviability was calculated by the following formula.

Cell viability (%)=100×[(luminescence of GGA-treatedgroup)/(luminescence of base-treated group)]

The stored cell culture supernatant was allowed to warm to roomtemperature, and the IL-8 concentration was quantified with HumanCXCL8/IL-8 Quantikine ELISA Kit (R&D Systems). The procedure wasperformed in accordance with the instruction manual attached to the kitand the measured absorbance was corrected by dividing it by the cellviability. The measurement of the absorbance was performed using amicroplate reader (VersaMax, Molecular Devices) at a measurementwavelength of 450 nm and a correction wavelength of 540 nm (temperaturein the chamber: 20 to 25° C.). The IL-8 concentration of each treatmentgroup was obtained by calculating an IL-8 concentration corresponding tothe corrected measured value and subtracting, from it, the IL-8concentration of the non-treated group as a background.

The results are shown in FIG. 5. As is apparent from FIG. 5, the grouptreated with GGA having a weight ratio of the all-trans form: the5Z-mono-cis form of 10:0 (the all-trans form only) showed a significantinhibitory effect on IL-8 production as compared with the group treatedwith GGA having a weight ratio of the all-trans form: the 5Z-mono-cisform of 6:4 (n=3, *: P<0.05, by Tukey-Kramer test).

(6) Evaluation of Protective Effect for Retinal Ganglion Cells AgainstNerve Damage Inducing Action of NMDA

In recent years the glutamate analogue NMDA (N-methyl-D-aspartate) hasbeen widely reported to be one of causative agents of neurodegenerativediseases including Alzheimer's disease. In the ophthalmic field, NMDA isconsidered to be involved in optic nerve damage in glaucoma (BrainResearch Bulletin, 81 (2010) 349-358). Accordingly, in this experimentrat models with glaucoma induced by NMDA were used to evaluate theneuroprotective effect of GGA.

Evaluation Method

To Sprague-Dawley (SD) rats, the all-trans form, the 5Z-mono-cis formand teprenone were separately pre-administered by oral administration(Test Example 1), intravitreal administration (Test Example 2) or ocularinstillation administration (Test Example 3) and 5 μL of NMDA wasadministered into the vitreous body to induce nerve damage. For TestExample 2, a marketed therapeutic eye drop for glaucoma, AIPHAGAN (tradename), was intravitreally administered as a positive control once a dayfor five days. For each of Test Examples, a base not containing GGA orAIPHAGAN was administered as a control in the same manner as describedabove.

The dosage and regimen of Test Examples 1 to 3 are shown in Table 1 andthe constitution of the base used in each tests are shown in Table 2.

TABLE 1 Damage Pre-administration (GGA) induction Frequency of (NMDA)Route of Administered Administration administration Administeredadministration concentration period per day concentration Test Oral 800mg/kg 2 days 1 4 mM Example 1 Test Intravitreal 0.05% w/v 5 days 1 40mM  Example 2 Test Ocular 1% w/v 5 days 5 4 mM Example 3 instillation

TABLE 2 Test Test Test g/100 mL Example 1 Example 2 Example 3 Gum arabic5.000 — — α-tocopherol 0.200 — — Boric acid — 1.300 1.300 Borax — 0.4000.400 Polysorbate 80 — 2.000 2.000 POE hydrogenated — 2.000 2.000 castoroil 60 POE castor oil — 0.100 0.100 Dibutylhydroxytoluene — 0.005 0.005Purified water q.s. q.s. q.s.

Three days after administration of NMDA, the eyeballs were harvested,fixed with half Karnovsky's fixative for 24 hours, embedded in paraffin,thin sectioned and stained with hematoxylin-eosin (HE) to preparehistopathological sections. The histological sections were observedunder an optical microscope and the thickness (μm) of the innerplexiform layer (IPL) of the retina was measured. From the thickness ofthe inner plexiform layer (IPL) of the retina, the neuroprotectiveeffects of the test preparations were evaluated.

Results

The results of Test Example 1 are shown in FIG. 6. As is apparent fromFIG. 6, in the case of oral administration, the all-trans form and the5Z-mono-cis form showed significant neuroprotective effects againstnerve damage by NMDA as compared with the base (*p<0.05, **<0.01, byDunnett's multiple comparison test). On the other hand, teprenone (theall-trans form: the 5Z-mono-cis form=6:4 (weight ratio)) did not show asignificant neuroprotective effect.

The results of Test Example 2 are shown in FIG. 7. As is apparent fromFIG. 7, in the case of intravitreal administration, the all-trans formand the 5Z-mono-cis form showed significant neuroprotective effectsagainst nerve damage by NMDA as compared with the base (***p<0.001, byTukey-Kramer multiple comparison test). Even compared with AIPHAGAN(trade name) Ophthalmic Solution 0.1% (Senju Pharmaceutical), which isconsidered to have a neuroprotective effect, the all-trans form showed asignificantly superior neuroprotective effect (*p<0.05, by Tukey-Kramermultiple comparison test).

The photomicrographs of the histological sections of Test Example 2 areshown in FIG. 8.

The results of Test Example 3 are shown in FIG. 9. As is apparent fromFIG. 9, in the case of ocular instillation administration, the all-transform showed a significant neuroprotective effect against nerve damage byNMDA as compared with the base (*p<0.05, by t-test).

(7) White Turbidity Reduction Test at Low Temperature StoragePreparation of Eye Drops

Eye drops containing a marketed teprenone, GGA at different weightratios (all-trans form: 5Z-mono-cis form=7:3, 8:2, 9:1, etc. (weightratio)), or GGA consisting of the all-trans form purified by the abovemethod were prepared as follows.

Specifically, to a surfactant (polysorbate 80) warmed to 65° C., theGGAs and GGA consisting of the all-trans form were separately added anddissolved under stirring in a hot water bath at 65° C. for 2 minutes.Water at 65° C. was added and each buffer was added under stirring togive a homogeneous solution. The pH and osmotic pressure were adjustedwith hydrochloric acid and/or sodium hydroxide. This resulting solutionwas filtered through a membrane filter with a pore size of 0.2 μm(bottle top filter, Thermo Fisher Scientific) to give a clear sterileeye drop.

The constitutions of the eye drops are shown in Tables 3 to 8 below.

Before the preparation of the sterile eye drops, it was confirmed byHPLC described later that adsorption of GGA to instruments etc., whichleads to the loss of the GGA content, did not occur during thepreparation procedure.

Measurement Method for GGA Concentration

In accordance with the measurement conditions for the elution testdescribed in PFSB/ELD Notification No. 0412007 “teprenone 100 mg/g finegranule”, the GGA concentration of each eye drop was determined from thearea value of the 5Z-mono-cis form (Ac) and the area value of theall-trans form (At) using Japanese pharmacopoeia “teprenone referencestandard (all-trans form: 5Z-mono-cis form=about 6:4 (weight ratio),Pharmaceutical and Medical Device Regulatory Science Society of Japan)”or teprenone (Wako Pure Chemical Industries) as a reference standardunder the HPLC measurement conditions described below. For the eye dropcontaining teprenone (all-trans form: 5Z-mono-cis form=3:2 (weightratio)), the GGA content was calculated by summing the amounts of theall-trans form and the 5Z-mono-cis form.

<HPLC Measurement Conditions>

Detector: ultraviolet absorption spectrometer (measurementwavelength: 210 nm)Column: YMC-Pack ODS-A (inner diameter: 4.6 mm, length: 15 cm,particle diameter: 3 μm)Column temperature: 30° C.Mobile phase: 90% acetonitrile solutionFlow rate: 1.2 to 1.3 mL/min (the 5Z-mono-cis form and the all-transform are eluted in this order.)Injection volume: 5 μL of 0.05 g/100 mL sample

Storage at Low Temperature

A 10 mL clear glass container (Nichiden-Rika Glass) was completelyfilled with each of the prepared eye drops (so that no air spaceremained). After sealing of the container, the eye drops were stored at4° C. Immediately after the preparation and after stored at 4° C. forthree days, 0.2 mL of each eye drop was transferred to wells of a96-well plate (flat bottom, polystyrene) with a glass graduated pipette,and the absorbance was measured at 660 nm with a microplate reader(VersaMax, Molecular Devices) (temperature in the chamber: 20 to 25°C.). As referred to in JIS K0101 (Testing methods for industrial water,measurement of turbidity by light transmission), the absorbance at 660nm of each sample was used as the indicator for white turbidity (thedegree of turbidity).

The test procedure was carried out quickly. Before the test procedurewas carried out, it was confirmed that the loss of the GGA content didnot occur during the storage at 4° C. or the measurement of absorbance.

The degrees of turbidity were summarized with other data in Tables 3 to6 below.

TABLE 3 Comparative Comparative Control g/100 mL Example 1 Example 2Example 3 Example 1 Example 2 (water) All-trans form 0.05 — — — — —All-trans form: — 0.05 — — — — 5Z-mono-cis form weight ratio (9:1)All-trans form: — — 0.05 — — — 5Z-mono-cis form weight ratio (8:2)All-trans form: — — — 0.05 — — 5Z-mono-cis form weight ratio (7:3)All-trans form: — — — — 0.05 — 5Z-mono-cis form weight ratio (6:4)Sodium dihydrogen 2.00 2.00 2.00 2.00 2.00 — phosphate dihydrateDisodium hydrogen 0.40 0.40 0.40 0.40 0.40 — phosphate dodecahydratePolysorbate 80 0.25 0.25 0.25 0.25 0.25 — Hydrochloric acid q.s. q.s.q.s. q.s. q.s. — Sodium hydroxide q.s. q.s. q.s. q.s. q.s. — Purifiedwater q.s. q.s. q.s. q.s. q.s. q.s. pH 5.7 5.7 5.7 5.7 5.7 — Osmoticpressure 270 270 270 270 270 — mOsm Immediately after 0.0358 0.03560.0377 0.0395 0.0401 0.0361 production 660 nm 4° C. 3 days 660 nm 0.07620.0922 0.1042 0.1137 0.1250 0.0353

TABLE 4 Comparative Comparative Control g/100 mL Example 4 Example 5Example 6 Example 3 Example 4 (water) All-trans form 0.05 — — — — —All-trans form: — 0.05 — — — — 5Z-mono-cis form weight ratio (9:1)All-trans form: — — 0.05 — — — 5Z-mono-cis form weight ratio (8:2)All-trans form: — — — 0.05 — — 5Z-mono-cis form weight ratio (7:3)All-trans form: — — — — 0.05 — 5Z-mono-cis form weight ratio (6:4)Sodium dihydrogen 1.40 1.40 1.40 1.40 1.40 — phosphate dihydrateDisodium hydrogen 1.40 1.40 1.40 1.40 1.40 — phosphate dodecahydratePolysorbate 80 0.25 0.25 0.25 0.25 0.25 — Hydrochloric acid q.s. q.s.q.s. q.s. q.s. — Sodium hydroxide q.s. q.s. q.s. q.s. q.s. — Purifiedwater q.s. q.s. q.s. q.s. q.s. q.s. pH 6.5 6.5 6.5 6.5 6.5 — Osmoticpressure 260 260 260 260 260 — mOsm Immediately after 0.0360 0.03570.0356 0.0401 0.0400 0.0361 production 660 nm 4° C. 3 days 660 nm 0.07340.0873 0.0993 0.1134 0.1164 0.0353

TABLE 5 Comparative Comparative Control g/100 mL Example 7 Example 8Example 9 Example 5 Example 6 (water) All-trans form 0.05 — — — — —All-trans form: — 0.05 — — — — 5Z-mono-cis form weight ratio (9:1)All-trans form: — — 0.05 — — — 5Z-mono-cis form weight ratio (8:2)All-trans form: — — — 0.05 — — 5Z-mono-cis form weight ratio (7:3)All-trans form: — — — — 0.05 — 5Z-mono-cis form weight ratio (6:4)Sodium dihydrogen 0.30 0.30 0.30 0.30 0.30 — phosphate dihydrateDisodium hydrogen 3.20 3.20 3.20 3.20 3.20 — phosphate dodecahydratePolysorbate 80 0.25 0.25 0.25 0.25 0.25 — Hydrochloric acid q.s. q.s.q.s. q.s. q.s. — Sodium hydroxide q.s. q.s. q.s. q.s. q.s. — Purifiedwater q.s. q.s. q.s. q.s. q.s. q.s. pH 7.5 7.5 7.5 7.5 7.5 — Osmoticpressure 260 260 260 260 260 — mOsm Immediately after 0.0358 0.03400.0374 0.0397 0.0366 0.0361 production 660 nm 4° C. 3 days 660 nm 0.07170.0837 0.0939 0.1065 0.1056 0.0353

TABLE 6 Example Example Example Comparative Comparative Control g/100 mL10 11 12 Example 7 Example 8 (water) All-trans form 0.05 — — — — —All-trans form: — 0.05 — — — — 5Z-mono-cis form weight ratio (9:1)All-trans form: — — 0.05 — — — 5Z-mono-cis form weight ratio (8:2)All-trans form: — — — 0.05 — — 5Z-mono-cis form weight ratio (7:3)All-trans form: — — — — 0.05 — 5Z-mono-cis form weight ratio (6:4) Boricacid 1.30 1.30 1.30 1.30 1.30 — Borax 0.40 0.40 0.40 0.40 0.40 —Polysorbate 80 0.25 0.25 0.25 0.25 0.25 — Hydrochloric acid q.s. q.s.q.s. q.s. q.s. — Sodium hydroxide q.s. q.s. q.s. q.s. q.s. — Purifiedwater q.s. q.s. q.s. q.s. q.s. q.s. pH 7.5 7.5 7.5 7.5 7.5 — Osmoticpressure 240 240 240 240 240 — mOsm Immediately after 0.0352 0.03750.0372 0.0389 0.0394 0.0361 production 660 nm 4° C. 3 days 660 nm 0.18260.1919 0.1962 0.2373 0.2302 0.0353

The results in Tables 3 to 6 revealed that white turbidity after storageat 4° C. was significantly reduced in the eye drops containing theall-trans form in an amount of 80% by weight or more.

A 10 mL clear glass container (Nichiden-Rika Glass) was completelyfilled with each of the prepared eye drops (so that no air spaceremained). After sealing of the container, the eye drops were stored at4° C. After stored at 4° C. for 6 days or 14 days, the absorbance wasmeasured at 660 nm in the same manner as described above and used as theindicator for the degree of turbidity. Each sample was measured (n=4 orn=5) and comparison with control (water) was performed by Dunnett test.

The measurement results of the degree of turbidity are shown with theresults of the test in Table 7 below. The photograph of the eye dropstored at 4° C. for 14 days is shown in FIG. 10 (left: ComparativeExample 10, right: Example 13).

TABLE 7 Example Example Comparative Comparative Control g/100 mL 13 14Example 9 Example 10 (water) All-trans form 0.05 — — — — All-trans form:— 0.05 — — — 5Z-mono-cis form weight ratio (8:2) All-trans form: — —0.05 — — 5Z-mono-cis form weight ratio (7:3) All-trans form: — — — 0.05— 5Z-mono-cis form weight ratio (6:4) Sodium dihydrogen 0.30 0.30 0.300.30 — phosphate dihydrate Disodium hydrogen 3.20 3.20 3.20 3.20 —phosphate dodecahydrate Polysorbate 80 0.35 0.35 0.35 0.35 —Hydrochloric acid q.s. q.s. q.s. q.s. — Sodium hydroxide q.s. q.s. q.s.q.s. — Purified water q.s. q.s. q.s. q.s. q.s. pH 7.5 7.5 7.5 7.5 —Osmotic pressure 260 260 260 260 — mOsm 4° C. 1 0.0392 0.0383 0.04080.0395 0.0359 6 days 2 0.0384 0.0394 0.0396 0.0396 0.0364 660 nm 30.0382 0.0386 0.0387 0.0405 0.0393 4 0.0381 0.0383 0.0391 0.0396 0.0369Mean 0.0385 0.0387 0.0396 0.0398 0.0371 SD 0.0005 0.0005 0.0009 0.00050.0015 P-value 0.1368 0.0823 0.0048 0.0022 — 4° C. 1 0.0396 — — 0.06440.0372 14 days 2 0.0411 — — 0.0693 0.0364 660 nm 3 0.0459 — — 0.07340.0399 4 0.0411 — — 0.0683 0.0379 5 0.0406 — — 0.0695 0.0358 Mean 0.0417— — 0.0690 0.0374

The results in Table 7 revealed that white turbidity after storage at 4°C. was significantly reduced in the eye drops containing the all-transform in an amount of 80% by weight or more.

The results of Examples 7 to 12 are extracted from Tables and 6 andshown in Table 8.

TABLE 8 Example Example Example Example Example Example g/100 mL 7 8 910 11 12 All-trans form 0.05 — — 0.05 — — All-trans form: — 0.05 — —0.05 — 5Z-mono-cis form weight ratio (9:1) All-trans form: — — 0.05 — —0.05 5Z-mono-cis form weight ratio (8:2) Sodium dihydrogen 0.30 0.300.30 — — — phosphate dihydrate Disodium hydrogen 3.20 3.20 3.20 — — —phosphate dodecahydrate Boric acid — — — 1.30 1.30 1.30 Borax — — — 0.400.40 0.40 Polysorbate 80 0.25 0.25 0.25 0.25 0.25 0.25 Hydrochloric acidq.s. q.s. q.s. q.s. q.s. q.s. Sodium hydroxide q.s. q.s. q.s. q.s. q.s.q.s. Purified water q.s. q.s. q.s. q.s. q.s. q.s. pH 7.5 7.5 7.5 7.5 7.57.5 Osmotic pressure 260 260 260 240 240 240 mOsm Immediately after0.0358 0.0340 0.0374 0.0352 0.0375 0.0372 production 660 nm 4° C. 3 days660 nm 0.0717 0.0837 0.0939 0.1826 0.1919 0.1962

White turbidity after storage at low temperature was clearly reduced inthe eye drops containing the phosphate buffering agents as compared withthe eye drops containing the borate buffering agents.

(8) White Turbidity Reduction Test at Normal Temperature Storage

The preparation of eye drops and the measurement of the GGAconcentration were performed in the same manner as in “(7) Whiteturbidity reduction test at low temperature storage” except thatfiltration in the preparation of the eye drops was not performed due tohigh concentration of GGA. The constitutions of the eye drops are shownin Table 9.

A 10 mL clear glass container (Nichiden-Rika Glass) was completelyfilled with the prepared eye drops (so that no air space remained).After sealing of the container, the eye drops were stored at roomtemperature (about 25° C.). After stored for three days, 0.2 mL of eachof the eye drops was transferred to wells of a 96-well plate (flatbottom, polystyrene) with a glass graduated pipette, and the absorbancewas measured at 660 nm with a microplate reader (VersaMax, MolecularDevices) (temperature in the chamber: 20 to 25° C.). As referred to inJIS K0101 (Testing methods for industrial water, measurement ofturbidity by light transmission), the absorbance at 660 nm of eachsample was used as the indicator for white turbidity (the degree ofturbidity).

Each sample was measured (n=4) and comparison was performed by t-testbetween Comparative Example 11 and Example 13 and between ComparativeExample 12 and Example 14. The results are shown in Table 9.

TABLE 9 Comparative Comparative g/100 mL Example 13 Example 11 Example14 Example 12 Water All-trans form 3.000 — 1.000 — — All-trans form: —3.000 — 1.000 — 5Z-mono-cis form weight ratio (6:4) Sodium dihydrogen1.300 1.300 1.300 1.300 — phosphate dihydrate Disodium hydrogen 0.4000.400 0.400 0.400 — phosphate dodecahydrate POE castor oil 0.300 0.3000.100 0.100 — POE hydrogenated 6.000 6.000 2.000 2.000 — castor oil 60Polysorbate 80 6.000 6.000 2.000 2.000 — Hydrochloric acid q.s. q.s.q.s. q.s. — Sodium hydroxide q.s. q.s. q.s. q.s. — Purified water q.s.q.s. q.s. q.s. q.s. pH 7.64 7.61 7.59 7.55 — Osmotic pressure 307 314255 253 — mOsm Room 1 0.3521 0.7947 0.1786 0.3431 0.0372 temperature 20.3631 0.8349 0.1800 0.3561 0.0368 3 days 3 0.3633 0.7953 0.1805 0.35100.0373 660 nm 4 0.3591 0.7979 0.1914 0.3399 0.0379 Mean 0.3594 0.80570.1826 0.3475 0.0373 P-value ≦0.001 ≦0.001 —

As is apparent from Table 9, white turbidity was significantly reducedin the eye drop containing relatively high concentration of theall-trans form as compared with the eye drop containing teprenone (theall-trans form: the 5Z-mono-cis form=6:4 (weight ratio)).

(9) Sensory Analysis

To a surfactant (polysorbate 80, POE castor oil) warmed to 65° C.,teprenone and the all-trans form were separately added and dissolvedunder stirring in a hot water bath at 65° C. for 2 minutes. Water at 65°C. was added and each buffer was added under stirring to give ahomogeneous solution. The pH and osmotic pressure were adjusted withhydrochloric acid and/or sodium hydroxide. This resulting solution wasfiltered through a membrane filter with a pore size of 0.2 μm (bottletop filter, Thermo Fisher Scientific) to give a clear sterile eye drop.The constitutions of the eye drops are shown in Table 10 below. Each ofthe eye drops was filled into a polyethylene terephthalate container (8mL) in an aseptic manner.

About 30 μL of these eye drops were instilled into the eyes ofnon-contact lens-wearing nine healthy volunteers who were sensitive toirritating feeling (aged 33.8±6.6, eight male and one female) and thedegrees of the “sting” in the eyes felt immediately after and 3 minutesafter the instillation were evaluated by the VAS method (Visual AnalogueScale: visual assessment scale) (double blind study).

The results are shown in Table 10.

TABLE 10 Comparative g/100 mL Example 17 Example 13 All-trans form 0.05— All-trans form:5Z-mono-cis form — 0.05 weight ratio (6:4) Boric acid1.30 1.30 Borax 0.40 0.40 POE castor oil 0.02 0.02 Polysorbate 80 0.500.50 Hydrochloric acid q.s. q.s. Sodium hydroxide q.s. q.s. Purifiedwater q.s. q.s. pH 7.5 7.5 Osmotic pressure mOsm 240 240 Immediatelyafter instillation 19.3 37.3 VAS mean (%) 3 minutes after instillation19.7 31.7 VAS mean (%)

The results in Table 10 revealed that when the eye drop prepared withthe all-trans form was used, “sting” in the eyes immediately after and 3minutes after the instillation was significantly reduced, as comparedwith when the eye drop prepared with teprenone was used.

(10) Thermal Stability Test

To a surfactant (polysorbate 80, POE castor oil) warmed to 65° C., theall-trans form was added and dissolved under stirring in a hot waterbath at 65° C. for 2 minutes. Water at 65° C. was added and each bufferwas added under stirring to give a homogeneous solution. The pH andosmotic pressure were adjusted with hydrochloric acid and/or sodiumhydroxide. This resulting solution was filtered through a membranefilter with a pore size of 0.2 μm (bottle top filter, Thermo FisherScientific) to give a clear sterile eye drop. The constitutions of theeye drops are shown in Table 11 below. A polyethylene terephthalatecontainer (8 mL) (the container for Rohto Dryaid EX, RohtoPharmaceutical) was completely filled with each of the eye drops in anaseptic manner.

For these eye drops, the stability test was performed by leaving them tostand in the upright position at 40° C., 50° C., or 60° C. for 10 daysor 20 days. The all-trans form content in each sample was quantifiedusing Japanese pharmacopoeia “teprenone reference standard (all-transform:5Z-mono-cis form=about 6:4 (weight ratio), Pharmaceutical andMedical Device Regulatory Science Society of Japan)” as a referencestandard, and the residual ratio (%) was calculated. The total amount ofthe all-trans form and the mono-cis form in the reference standard werecalculated as the GGA content.

Residual ratio (%)=100×[all-trans form content after being left to standfor predetermined period of time (g/100 mL)/all-trans form contentimmediately after production (g/100 mL)]

The results are shown in Table 11.

TABLE 11 Exam- Exam- Exam- Exam- g/100 mL ple 18 ple 19 ple 20 ple 21All-trans form 0.05 0.05 0.05 0.05 Sodium dihydrogen 2.00 1.40 0.30 —phosphate dihydrate Disodium hydrogen 0.40 1.40 3.20 — phosphatedodecahydrate Boric acid — — — 1.30 Borax — — — 0.40 POE castor oil 0.020.02 0.02 0.02 Polysorbate 80 0.50 0.50 0.50 0.50 Hydrochloric acid q.s.q.s. q.s. q.s. Sodium hydroxide q.s. q.s. q.s. q.s. Purified water q.s.q.s. q.s. q.s. pH 5.7 6.5 7.5 7.5 Osmotic pressure 270 260 260 240 mOsmResidual 40° C. 20 days 98.4 98.0 99.5 96.7 ratio 50° C. 20 days 91.994.3 99.6 72.4 (%) 60° C. 10 days 84.8 90.7 97.2 72.5 60° C. 20 days67.3 81.1 91.2 48.5

The eye drops containing the phosphate buffering agents showed clearlyhigher residual ratios of the all-trans form and thus more excellent inthe thermal stability, as compared with the eye drop containing theborate buffering agents. In terms of the pH range of 5.7 to 7.5, the eyedrops having higher pH values showed higher residual ratios of theall-trans form and thus more excellent in the thermal stability.

(11) Light Stability Test

To a surfactant (polysorbate 80, POE castor oil) warmed to 65° C., theall-trans form was added and dissolved under stirring in a hot waterbath at 65° C. for 2 minutes. Water at 65° C. was added and each bufferwas added under stirring to give a homogeneous solution. The pH andosmotic pressure were adjusted with hydrochloric acid and/or sodiumhydroxide. This resulting solution was filtered through a membranefilter with a pore size of 0.2 μm (bottle top filter, Thermo FisherScientific) to give a clear sterile eye drop. The constitutions of theeye drops are shown in Table 12 below. A polyethylene terephthalatecontainer (8 mL) (the container for Rohto Dryaid EX, RohtoPharmaceutical) was completely filled with each of the eye drops in anaseptic manner.

Each eye drop was subjected to light irradiation under the followingconditions. The all-trans form content in each sample was quantifiedimmediately after the production and after the irradiation and theresidual ratio (%) was calculated.

Irradiation equipment: LTL-200A-15WCD (Nagano Science)Light source: D-65 lampTotal irradiation, temperature and humidity: 1,300,000 lx·h (4000 lx×325hours), 25° C., 60% RHDirection of light irradiation: the light was irradiated from the top tothe container left to stand in the upright position on the spinning diskof the equipment.

Residual ratio (%)=100×[all-trans form content after light irradiation(g/100 mL)/all-trans form content immediately after production (g/100mL)]

The results are shown in Table 12.

TABLE 12 Example Example Example Example g/100 mL 22 23 24 25 All-transform 0.005 0.05 0.005 0.05 Sodium dihydrogen 0.30 0.30 — — phosphatedihydrate Disodium hydrogen 3.20 3.20 — — phosphate dodecahydrate Boricacid — — 1.30 1.30 Borax — — 0.40 0.40 POE castor oil 0.002 0.02 0.0020.02 Polysorbate 80 0.050 0.50 0.050 0.50 Hydrochloric acid q.s. q.s.q.s. q.s. Sodium hydroxide q.s. q.s. q.s. q.s. Purified water q.s. q.s.q.s. q.s. pH 7.5 7.5 7.5 7.5 Osmotic pressure 260 260 240 240 mOsmResidual ratio (%) 90.5 92.8 86.1 89.0

The eye drops containing the phosphate buffering agents showed clearlyhigher residual ratios of the all-trans form and thus more excellent inthe light stability, as compared with the eye drops containing theborate buffering agents.

(12) Test for Reduction in Adsorption to Contact Lenses

To a surfactant (polysorbate 80) warmed to 65° C., the all-trans form ora mixture of the all-trans form and the 5Z-mono-cis form (weightratio=8:2) were separately added and dissolved under stirring in a hotwater bath at 65° C. for 2 minutes. Water at 65° C. was added and eachbuffer was added under stirring to give a homogeneous solution. The pHand osmotic pressure were adjusted with hydrochloric acid and/or sodiumhydroxide. This resulting solution was filtered through a membranefilter with a pore size of 0.2 μm (bottle top filter, Thermo FisherScientific) to give a clear sterile eye drop. The constitutions of theeye drops are shown in Table 13 below. A4 mL clear glass container(Nichiden-Rika Glass) was completely filled with each eye drop.

One soft contact lens (hereinafter SCL: ACUVUE OASIS (Johnson & Johnson,approval number: 21800BZY10252000, base curve: 8.4 mm, diameter: 14.0mm, power: −3.00 D) was immersed in 4 mL of each eye drop (immersionsolution) and left to stand in the upright position at 25° C. for 14hours. Each SCL had been initialized before use through immersion in 10mL of physiological saline (Otsuka Normal Saline) overnight after beingtaken out from the package solution.

For 4 mL of the eye drop without immersion of SCL (blank solution), thesame procedure as those for the eye drops with immersion of SCL(immersion solution) was performed. The amount of the all-trans form orthe amount of the mixture of the all-trans form and the 5Z-mono-cis formwas quantified by HPLC for each of the blank solution and the immersionsolution, and the difference in the amounts between the blank solutionand the immersion solution was used to calculate the amount ofadsorption to SCL (μg/lens) (n=2).

Amount of adsorption (μg/lens)=[(amount of all-trans form or amount ofmixture of all-trans form and 5Z-mono-cis form (weight ratio=8:2) inblank solution (g/100 mL)−amount of all-trans form or amount of mixtureof all-trans form and 5Z-mono-cis form (weight ratio=8:2) in immersionsolution (g/100 mL))/100]×4×1000×1000

The results are shown in Table 13.

TABLE 13 Example Example Ex-ample Example Example Example g/100 mL 26 2728 29 30 31 All-trans form 0.05 — 0.05 — 0.05 — All-trans form: — 0.05 —0.05 — 0.05 5Z-mono-cis form weight ratio (8:2) Sodium dihydrogen 2.002.00 0.30 0.30 — — phosphate dihydrate Disodium hydrogen 0.40 0.40 3.203.20 — — phosphate dodecahydrate Boric acid — — — — 1.30 1.30 Borax — —— — 0.40 0.40 Polysorbate 80 0.25 0.25 0.25 0.25 0.25 0.25 Hydrochloricacid q.s. q.s. q.s. q.s. q.s. q.s. Sodium hydroxide q.s. q.s. q.s. q.s.q.s. q.s. Purified water q.s. q.s. q.s. q.s. q.s. q.s. pH 5.7 5.7 7.57.5 7.5 7.5 Osmotic pressure 270 270 260 260 240 240 mOsm Amount ofadsorption (μg/lens) 152.8 165.5 146.4 148.0 222.4 183.4 132.8 151.3156.3 134.4 219.7 180.7

The eye drops containing the phosphate buffering agents showed clearlyreduced adsorption of GGA to contact lenses, as compared with the eyedrops containing the borate buffering agents.

INDUSTRIAL APPLICABILITY

The agent of the present invention is excellent in the prophylactic,ameliorating or therapeutic effect for a retinal disease and is alsoexcellent as a preparation having advantages such that white turbidityafter low temperature is reduced, etc.

1. A method for preventing, ameliorating or treating a retinal disease,the method comprising the step of administering to a patient with aretinal disease an effective amount of geranylgeranylacetone which (a)is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more, (b) consists of(5E,9E,13E)-geranylgeranylacetone, or (c) consists of(5Z,9E,13E)-geranylgeranylacetone, thereby preventing, ameliorating ortreating the retinal disease.
 2. The method according to claim 1,comprising administering an ophthalmic composition comprisinggeranylgeranylacetone to the eye of a patient with a retinal disease. 3.The method according to claim 2, wherein the geranylgeranylacetonecontent of the ophthalmic composition is 0.00001 to 10% by weightrelative to the total amount of the preparation.
 4. The method accordingto claim 1, comprising orally administering an oral agent comprisinggeranylgeranylacetone to a patient with a retinal disease.
 5. The methodaccording to claim 4, wherein the geranylgeranylacetone content of theoral agent is 0.001 to 80% by weight relative to the total amount of thepreparation.
 6. The method according to claim 1, wherein the retinaldisease is a disease selected from the group consisting of glaucoma,retinitis pigmentosa, age-related macular degeneration and diabeticretinopathy.
 7. A method for protecting a retinal cell, the methodcomprising the step of administering to a patient with a retinal diseasean effective amount of geranylgeranylacetone which (a) is a mixture of(5E,9E,13E)-geranylgeranylacetone and (5Z,9E,13E)-geranylgeranylacetone,the (5E,9E,13E)-geranylgeranylacetone content of the mixture being 80%by weight or more, (b) consists of (5E,9E,13E)-geranylgeranylacetone, or(c) consists of (5Z,9E,13E)-geranylgeranylacetone, thereby protecting aretinal cell.
 8. The method according to claim 7, comprisingadministering an ophthalmic composition comprising geranylgeranylacetoneto the eye of a patient with a retinal disease.
 9. The method accordingto claim 8, wherein the geranylgeranylacetone content of the ophthalmiccomposition is 0.00001 to 10% by weight relative to the total amount ofthe preparation.
 10. The method according to claim 7, comprising orallyadministering an oral agent comprising geranylgeranylacetone to apatient with a retinal disease.
 11. The method according to claim 10,wherein the geranylgeranylacetone content of the oral agent is 0.001 to80% by weight relative to the total amount of the preparation.
 12. Themethod according to claim 7, wherein the retinal disease is a diseaseselected from the group consisting of glaucoma, retinitis pigmentosa,age-related macular degeneration and diabetic retinopathy.
 13. A methodfor suppressing the degeneration, impairment or destruction of a retinalcell, the method comprising the step of administering to a patient witha retinal disease an effective amount of geranylgeranylacetone which (a)is a mixture of (5E,9E,13E)-geranylgeranylacetone and(5Z,9E,13E)-geranylgeranylacetone, the (5E,9E,13E)-geranylgeranylacetonecontent of the mixture being 80% by weight or more, (b) consists of(5E,9E,13E)-geranylgeranylacetone, or (c) consists of(5Z,9E,13E)-geranylgeranylacetone, thereby suppressing the degeneration,impairment or destruction of a retinal cell.
 14. The method according toclaim 13, comprising administering an ophthalmic composition comprisinggeranylgeranylacetone to the eye of a patient with a retinal disease.15. The method according to claim 14, wherein the geranylgeranylacetonecontent of the ophthalmic composition is 0.00001 to 10% by weightrelative to the total amount of the preparation.
 16. The methodaccording to claim 13, comprising orally administering an oral agentcomprising geranylgeranylacetone to a patient with a retinal disease.17. The method according to claim 16, wherein the geranylgeranylacetonecontent of the oral agent is 0.001 to 80% by weight relative to thetotal amount of the preparation.
 18. The method according to claim 13,wherein the retinal disease is a disease selected from the groupconsisting of glaucoma, retinitis pigmentosa, age-related maculardegeneration and diabetic retinopathy.